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Research Snapshot Theater: Patient and Family Support/Ethics and End of Life, Adult

Quality of Communication in Family Meetings Predicts Post-Meeting ICU Length of Stay

Sunday, March 22, 2026
12:15 PM - 1:15 PM Central Time
Location: Connections Central - RST 09
Introduction: We previously reported that communication quality during intensive care unit (ICU) goals of care family meetings reduced ICU length of stay (LOS; admission to discharge) using the validated methodology Communication Quality Analysis (CQA). This sensitivity analysis examines this finding stratified by ICU survivorship and post-family meeting ICU LOS (family meeting to discharge).


Methods: This is a secondary analysis from a cohort study of 168 audio-recorded family meetings from 6 ICUs. We applied CQA on goals-of-care conversations between clinicians and surrogates of non-capacitated patients with estimated >50% risk of severe long-term disability. 3 coders rated communication quality across 6 domains (content, engagement, emotion, relationship, face, accommodation) for both family members and clinicians on a 7-point scale, where 0.50 indicates a meaningful difference. Domain scores were used to calculate the Multiple Goals Scores (MGS; range 0–3; 0.25 indicates a meaningful difference) to assess communication quality broadly. Final CQA scores include both clinician and family communication reflecting overall meeting quality. Inter-rater reliability among coders was high (intraclass correlations range 0.68–0.93). Multivariable linear regression examined whether CQA scores predict post-meeting ICU LOS, controlling for patient age, race, ethnicity, sex, and APACHE II score, stratified by discharge disposition survival.


Results: Of the 168 surrogates, 78% were white, 67% female, mean age 52 (SD=13). Patients had mean APACHE II score 32 (SD=5) and mean post-meeting ICU stay of 12.48 days (SD=18.33). For every 0.25-unit increase in MGS, there was a 1.59-day decrease in post-meeting ICU LOS (95% CI –2.97 to –0.22; p=0.02) and among survivors only, post-meeting ICU LOS was significantly shortened (–2.62 days, 95% CI –4.86 to –0.39; p=0.02). A 0.50-unit increase in the relationship and accommodation domain scores was associated with shorter ICU LOS for non-survivors and face domain scores with significantly reduced ICU LOS in survivors.


Conclusions: CQA-measured communication quality predicts ICU LOS, though mechanisms may differ by discharge disposition survivorship. Findings support goal-sensitive communication training to improve care and outcomes. Further studies are needed to explore mechanisms.