The National Palliative Care Research Center

Curing suffering through palliative care research.


Kelly Michelson MD, MPH


Ann & Robert H. Lurie Children’s Hospital of Chicago

Grant Year
Grant Term
2 years
Grant Type
Pilot & Exploratory Project Support Grant

Project Description
Developing and Testing Criteria for Convening Family Conferences in the Pediatric Intensive Care Unit

Three decades of research demonstrate inadequacies in intensive care unit (ICU) communication. Poor ICU communication worsens patient care and family mental health outcomes. Conversely, high-quality ICU communication supports care that meet the needs of patients and their families while mitigating the psychological impact of critical illness on families. Experts recommend routine multidisciplinary ICU family conferences (FCs) to improve communication. FCs are planned meetings (excluding bedside rounds) with healthcare team members and patients and/or patient surrogates to discuss or determine treatment plans. Data about ICU FCs, mostly from studies of adult patients facing end-of-life care issues, show that FCs may enhance families’ satisfaction with communication and trust in clinicians, reduce clinician-family conflict, and support shared decision making. But such data have limited application in the pediatric intensive care unit (PICU) which serves a notably different population than adult ICUs. Also, current recommendations do not specify which PICU patients we should offer FCs. Our long-term goal is to positively impact healthcare outcomes for PICU patients and their families by improving PICU communication. The proposed project will develop and pilot reliable and inclusive (i.e., highly sensitive) criteria for determining which PICU families to offer FCs and obtain needed information about factors associated with PICU FC use and how parents view PICU FCs. We will: (1) develop reliable criteria for determining which PICU families to offer an FC; (2) assess the inclusivity of our developed FC criteria; and (3) describe parents’ views of PICU FCs and factors associated with having PICU FCs. This innovative research will culminate in inclusive and reliable criteria defining a target population for PICU FCs and obtain novel data about factors associated with PICU FC use and parents’ views about PICU FCs. These data will inform future studies aimed at improving PICU communication.    

Kelly Michelson, MD, MPH, is Professor of Pediatrics, Julia and David Uihlein Professor of Bioethics and Medical Humanities, and Director of the Center for Bioethics and Medical Humanities at Northwestern University Feinberg School of Medicine. She is an attending physician at Ann & Robert H. Lurie Children’s Hospital of Chicago in the division of pediatric critical care medicine. Dr. Michelson’s research interests include communication, decision making, palliative care, bereavement support, and bioethics. She uses qualitative and quantitative methods as well as patient/stakeholder engagement and community-based participatory research methods. Recent work has examined the use of a navigator in the pediatric intensive care unit setting, the role of social workers and spiritual care providers for critically ill pediatric patients with cancer, and access to bereavement support for people impacted by the death of a child.