Shared Decision Making to Improve Goals of Care Discussions in the Emergency Department
Overview
- Phase
- N/A
- Intervention
- Shared Decision Aid Assessment
- Conditions
- Goals
- Sponsor
- Mayo Clinic
- Enrollment
- 230
- Locations
- 3
- Primary Endpoint
- Patient and physician feedback survey for tool development and iterative refinement
- Status
- Recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
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.
Detailed Description
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.
Investigators
Laura E. Walker
Principal Investigator
Mayo Clinic
Eligibility Criteria
Inclusion Criteria
- •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.
Exclusion Criteria
- •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.
Arms & Interventions
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.
Intervention: Shared Decision Aid Assessment
Outcomes
Primary Outcomes
Patient and physician feedback survey for tool development and iterative refinement
Time Frame: 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.
Secondary Outcomes
- Patient and physician satisfaction questionnaire(1 year)