TOP 63 - Using Qualitative Methods to Inform the Development of a Family Meeting Educational Toolkit for Family Meetings on the Pediatric Hospital Medicine and Complex Care Services

Publication Number: 2816.TOP 63

Julie R. Barzilay, Boston Children's Hospital, Brookline, MA, United States; Julianna Lau, Boston Children's Hospital, Boston, MA, United States; Alyssa Coffin, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States; Sangeeta Mauskar, Boston Childrens Hospital, Southboro, MA, United States; Alisa Khan, Harvard Medical School/Boston Children's Hospital, Cambridge, MA, United States

Background: Best practices are unknown for conducting family meetings in patients admitted to pediatric hospital medicine (PHM) and complex care services (CCS), which have unique communication needs given multiple key partners and a focus on care coordination. Tools like checklists and frameworks have been shown to increase congruency in goals of care between providers and patients/families, as well as improve staff and patient/family satisfaction and understanding of medical updates.

Objective: To explore the unique communication landscape of family meetings on PHM and CCS using qualitative methods, and to co-design a multilingual Family Meeting Educational Toolkit for families and multidisciplinary team members.

Design/Methods: Our team is conducting 30-60-minute audio-recorded semi-structured interviews with individual multidisciplinary partners who participate in family meetings on PHM or CCS at a large quaternary free-standing children's hospital. Interview topics include goals, roles, emotional experiences, room setup/scheduling logistics, power dynamics, and family centeredness in family meetings. Each interviewee also provides feedback on toolkit materials which have been developed by the research team (based on literature reviews and expert input) to enhance communication at family meetings. These materials are simultaneously being reviewed and co-designed by Family Advisory Council members at our institution. Using a constructivist grounded theory approach, 3 coders are conducting inductive thematic analysis of the de-identified interview transcripts and developing a codebook. We have interviewed 13 participants to date: 2 attendings, 1 resident, 2 fellows, 1 nurse, 1 advanced practice provider, 1 social worker, 2 interpreters, and 3 family members. By December 2025, we plan to interview approximately 20 key stakeholders to reach code saturation. Our interviews have identified a need for additional structure around training providers to plan, conduct, lead, and document family meetings. We are accordingly revising our multilingual Family Meeting Toolkit with materials for both providers and families that outline steps for meeting preparation, partnering with families to set meeting agendas, and documenting and debriefing after meetings to facilitate improved communication at family meetings in the inpatient setting on the pediatrics floor. This study was deemed IRB-exempt by our institution's Institutional Review Board and is funded by the Boston Children's Hospital Health Professions Education Innovation Grant.

Figure 1. Emerging Themes from Provider Interviews
These preliminary themes emerging from our iterative coding analysis of de-identified interview transcripts are informing the ongoing revision of our Family Meeting Educational Toolkit

Figure 2. Family Meeting Educational Toolkit Representative Excerpts
These are representative excerpts from the Family Meeting Educational Toolkit that we are co-designing with multidisciplinary study participants and Family Advisory Council Members at our institution