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- W2574666043 abstract "•Identify language used in framing an ICU decision using the “needs frame.”•Identify language used in framing an ICU decision in the “parental autonomy frame.”•Demonstrate language that elicits values and builds trust. Pediatric staff working in intensive care units (ICU's) at children’s hospitals are increasingly caring for more chronically critically ill children. Decisions regarding initiation, continuation, escalation, or de-escalation of life-prolonging interventions occur frequently in our NICUs, PICUs and Pediatric Cardiac ICUs. Staff often perceive that decisions in the best interest of these children and their families are not always being made. Studies of substituted decision making in adult ICU’s suggests that a guided recommendation, as opposed to asking surrogates, “what do you want us to do?” leads to better acceptance of decisions, and perhaps better outcomes. We are sharing an approach that is becoming a part of the curriculum for professionals and trainees at our children’s hospitals. •After attending this session learners will be able to•Identify three ways in which providers frame decisions regarding life-prolonging interventions: the needs frame (paternalistic), the parental autonomy frame (informational, often collaborative) and the values-guided decision support frame (collaborative and deliberative).•Demonstrate specific language that can elicit values and build trust.•Demonstrate specific language that uses identified parental values to present a recommended decision that is shared by the family, but in which the burden of the decision is not borne by the parents alone.•Demonstrate the ability to listen for acceptance or the need for further conversation. Participants will watch two short videos in which conversations between parents and providers demonstrate common ways in which decisions are framed. This will be followed by a review of the literature regarding the framing observed in clinical practice, as well as the ethics literature regarding surrogate and shared decision making. A third short video will model language used to elicit values, establish trust and make a values guided recommendation. The importance of silence, and listening for parental feedback will be highlighted." @default.
- W2574666043 created "2017-01-26" @default.
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- W2574666043 date "2017-02-01" @default.
- W2574666043 modified "2023-09-30" @default.
- W2574666043 title "But the Parents Wanted Us to “Do Everything”: Using Values Guided Decision Support in Pediatric ICUs (FR472)" @default.
- W2574666043 doi "https://doi.org/10.1016/j.jpainsymman.2016.12.155" @default.
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