2295 - Life-Limiting Diagnosis in the Level IV NICU: Communication with Families facing Complex Decision-Making

Sunday, April 24, 2022

10:00 AM – 11:30 AM US MT

Location: Convention Center: 207

CE: Live CME: 1.5

Course Number: 2295

Leader(s)

Amy Schlegel, MD

Assistant Professor of Pediatrics
Nationwide Children's Hospital
Columbus, Ohio, United States

Co-Leader(s)

sujir nayak, MD (she/her/hers)

Assistant Professor of Pediatrics
pediatrics
UTSW -Dallas
Dallas, Texas, United States
Allison Black, Md

associate professor
University of Alabama School of Medicine
Mountain Brk, Alabama, United States
Jessica Fry, MD (she/her/hers)

Attending Neonatologist, Assistant Professor of Pediatrics
Pediatrics/Neonatology
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
CL

Con Yee Ling, MD (he/him/his)

Associate Professor
University of Utah
Salt Lake City, Utah, United States
Steve Leuthner, MD, MA (he/him/his)

Professor
Department of Pediatrics, Medical College of Wisconsin
Wauwatosa, Wisconsin, United States
Kevin Sullivan, MD, MBA

Clinical Associate Professor of Pediatrics
Pediatrics/Neonatology
Sidney Kimmel Medical College at Thomas Jefferson University
Wilmington, Delaware, United States

Participants should be aware of the following financial/non-financial relationships:

Amy B. Schlegel, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

sujir p. nayak, MBBS, FAAP: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Allison Black, Md: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Jessica T. Fry, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Con Yee Ling, MD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Steven R. Leuthner, MD, MA: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Kevin M. Sullivan, MD, MBA: I do not have any relevant financial / non-financial relationships with any proprietary interests.

While aggressive Level IV NICU care allows for survival and optimized outcomes for the vast majority of critically-ill neonates, some families experience a devastating reality that NICU diagnoses can become acutely life-limiting. These families are often asked to process grim prognostic information and make critical decisions in relatively close proximity. As physicians who care for complex neonates with multisystem diseases, genetic syndromes, and constellations of anomalies that are or may become acutely life-limiting, we recognize that provider communication skills can significantly impact the parental experience as well as a family’s ability to partner with the transdisciplinary team to ensure that medical care of their child is in line with their values and goals. Participants in this workshop will explore how utilization of clear, compassionate communication and effective shared decision-making can enhance support of families making decisions around the life and death of their child. Working in facilitated breakout groups, participants will cooperatively explore segments of a multilevel case constructed to emphasize the challenges of shared decision-making in a Level IV NICU. Participants will engage in collaborative discussion and deliberate practice involving assisting families in evolving goals of care with disease progression, facilitating multispecialty family discussions regarding options of life-sustaining interventions or therapies, exploring limitations to interventions or resuscitation with families focused on survival, and anticipatory guidance and parental choices around neonatal death.