Goals
Conditions
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.
Interventions
OTHERShared Decision Aid Assessment
Provide feedback on a shared decision making tool to aid in discussion on goals of care in the emergency department
Sponsors
Mayo Clinic
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Inclusion: 1. Patients presenting to Mayo Clinic Rochester, Saint Marys' Emergency Department, 2. Patients at high risk for critical illness as determined by an Elderly Risk Assessment (ERA) score ≥ 16 or as determined by provider discretion, 3. ≥ 60 years of age, 4. Ability to provide informed consent, 5. Medically stable at the time of enrollment, 6. Able to participate without causing a delay in care. Exclusion: 1. GCS scores \< 15, 2. Signs of altered mental status, 3. Known to be pregnant, 4. Incarcerated or in Police Custody, 5. Communication barriers such as visual or hearing impairment that may preclude use of the decision aid.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient and physician feedback survey for tool development and iterative refinement | 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
| Measure | Time frame | Description |
|---|---|---|
| Patient and physician satisfaction questionnaire | 1 year | A satisfaction questionnaire is filled out by the patient and his/her provider following conversation on goals of care either with or without the SDM intervention. |
Countries
United States
Contacts
CONTACTLaura Walker
CONTACTDerek VanMeter
PRINCIPAL_INVESTIGATORLaura E Walker
Mayo Clinic
Outcome results
None listed