Shared Decision Making to Improve Goals of Care Discussions in the Emergency Department
Mayo Clinic
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.
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 decisi…
Eligibility
- Age range
- 60+ years
- Sex
- All
- Healthy volunteers
- No
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 impairm…
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
Locations (3)
- Mayo Clinic in ArizonaScottsdale, Arizona
- Mayo Clinic in FloridaJacksonville, Florida
- Mayo Clinic in RochesterRochester, Minnesota