The Trauma Informed Family Meeting: A New Model of Information Sharing and Family Support During Cardiac Admission

While best practice guidelines for family meetings in pediatric CICU settings emphasize empathic listening, deliberation, and a focus on family experiences and values, recent research reveals that cardiac care teams face barriers when putting these guidelines into practice. Exposure to traumatic medical experiences impacts the degree to which both family members and cardiac clinicians are able to engage in collaborative conversations during family meetings. Instead, these meetings often become lengthy summaries of the patient's medical history, bringing us no closer to the goal of family centered partnership, an essential component of care for children with complex cardiac conditions. We propose the Trauma Informed Family Meeting (TIFM), which draws upon relational ethics, trauma informed care principles, and the most current empirical research on teamwork and family centered care in CICUs. Central to an effective TIFM are structured, pre-family meeting huddles, which provide opportunities for critical care teams to support one another, establish a shared understanding of medical facts and treatment recommendations, and develop an effective communication strategy. We propose guidelines for TIFMs, including those to be used before and during a TIFM. By shifting our perspective on the purpose of family meetings, a TIFM has the potential to set families on a trajectory to be fully engaged in treatment planning and medical decision-making, to ensure clinicians receive necessary supports, and for teams and families to emerge as strong partners in a child's cardiac care.