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Family Connect / Update Note
Family connect notes are written twice weekly (by Tuesday and Friday) per SurgCritCare. org orientation. They document family communication and are not intended to be long unless the psychosocial situation demands it.
On this page
On this page
- Date/Time:*
- Patient:*
- MRN:*
- Author:*
Contact Information
Method of contact: (bedside / phone) • Call initiated by: (family / care team)Section
Contact Information
Method of contact: (bedside / phone) • Call initiated by: (family / care team)- Person(s) contacted:
- Relationship to patient:
- Method of contact: (bedside / phone)
- Call initiated by: (family / care team)
Summary of Communication
Clinical update provided:*Section
Summary of Communication
Clinical update provided:*- Clinical update provided:*
- Key issues discussed:*
- (Current condition)
- (Recent changes)
- (Procedures or interventions)
- (Anticipated next steps)
Family Questions / Concerns
Questions raised:*Section
Family Questions / Concerns
Questions raised:*- Questions raised:*
- Responses given:*
Goals of Care
Current care level: (Full / DNR-CCA / CMO / Comfort focused) • Goals of care discussed: (yes / no / ongoing)Section
Goals of Care
Current care level: (Full / DNR-CCA / CMO / Comfort focused) • Goals of care discussed: (yes / no / ongoing)- Current care level: (Full / DNR-CCA / CMO / Comfort focused)
- Goals of care discussed: (yes / no / ongoing)
- Summary of discussion:
- Family understanding of prognosis:
- Decisions made / deferred:
Follow-Up
This note documents communication with the patient's family/support person. It is not a clinical care note and does not replace...Section
Follow-Up
This note documents communication with the patient's family/support person. It is not a clinical care note and does not replace...- Next family meeting planned:
- Outstanding questions for attending:
- Additional family members to notify:
- This note documents communication with the patient's family/support person. It is not a clinical care note and does not replace the ICU progress note.*