Shared Decision Making to Improve Goals of Care Discussions in the Emergency Department
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- Mayo Clinic
- 入组人数
- 230
- 试验地点
- 3
- 主要终点
- Patient and physician feedback survey for tool development and iterative refinement
研究概览
简要总结
This project will develop and refine a shared decision making (SDM) intervention (decision aid tool) to improve and normalize high quality end of life discussions in the Emergency Department (ED) setting.
详细描述
Develop a shared decision making (SDM) intervention informed by insights elicited from patients and clinicians to improve goals of care discussions.
The process of decision aid design involves: (1) review and synthesis of the evidence; (2) an analysis of usual practice through observation of clinical encounters; (3) development of an initial decision aid prototype; (4) field testing in the context of clinical care to gain insights on both intended and unintended effects of its use in practice to facilitate patient centered goals of care discussions; and (5) successive iterations of the decision aid until thematic saturation is reached and it is ready for testing in a clinical trial.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients presenting to Mayo Clinic Rochester, Saint Marys' Emergency Department,
- •Patients at high risk for critical illness as determined by an Elderly Risk Assessment (ERA) score ≥ 16 or as determined by provider discretion,
- •≥ 60 years of age,
- •Ability to provide informed consent,
- •Medically stable at the time of enrollment,
- •Able to participate without causing a delay in care.
排除标准
- •GCS scores < 15,
- •Signs of altered mental status,
- •Known to be pregnant,
- •Incarcerated or in Police Custody,
- •Communication barriers such as visual or hearing impairment that may preclude use of the decision aid.
研究组 & 干预措施
Shared decision aid assessment
Patients will be selected to have a goals of care discussion with an emergency physician utilizing a pilot decision aid and will be asked for feedback to assist with refinement of the decision aid.
干预措施: Shared Decision Aid Assessment (Other)
结局指标
主要结局
Patient and physician feedback survey for tool development and iterative refinement
时间窗: 1 year
A debrief survey/open-ended questionnaire is filled out by the patient and his/her provider to collect feedback. This is used to refine this shared decision making (SDM) intervention in the Emergency Department (ED) setting.
次要结局
- Patient and physician satisfaction questionnaire(1 year)
研究者
Laura E. Walker
Principal Investigator
Mayo Clinic