Communication Tools to Support Advance Care Planning and Hospital Care During the COVID-19 Pandemic: A Design Process
| Autor: | Sue Gullo, Erik K. Fromme, Evan M. Benjamin, Joanna Paladino, Namita Seth Mohta, Suzanne Mitchell, Nora Downey, Joshua R Lakin, Justin J. Sanders |
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| Rok vydání: | 2021 |
| Předmět: |
Advance care planning
Leadership and Management media_common.quotation_subject Decision Making MEDLINE Context (language use) Telehealth Article Advance Care Planning 03 medical and health sciences 0302 clinical medicine Humans Conversation 030212 general & internal medicine Pandemics media_common Medical education SARS-CoV-2 Event (computing) Communication 030503 health policy & services COVID-19 Hospitalization Risk perception 0305 other medical science Psychology Social vulnerability |
| Zdroj: | Joint Commission Journal on Quality and Patient Safety The Joint Commission Journal on Quality and Patient Safety |
| ISSN: | 1553-7250 |
| DOI: | 10.1016/j.jcjq.2020.10.005 |
| Popis: | The COVID-19 pandemic has exposed the medical and social vulnerability of an unprecedented number of people. Consequently, there has never been a more important time for clinicians to engage patients in advance care planning (ACP) discussions about their goals, values, and preferences in the event of critical illness. An evidence-based communication tool-the Serious Illness Conversation Guide-was adapted to address COVID-related ACP challenges using a user-centered design process: convening relevant experts to propose initial guide adaptations; soliciting feedback from key clinical stakeholders from multiple disciplines and geographic regions; and iteratively testing language with patient actors. With feedback focused on sharing risk about COVID-19-related critical illness, recommendations for treatment decisions, and use of person-centered language, the team also developed conversation guides for inpatient and outpatient use. These tools consist of open-ended questions to elicit perception of risk, goals, and care preferences in the event of critical illness, and language to convey prognostic uncertainty. To support use of these tools, publicly available implementation materials were also developed for clinicians to effectively engage high-risk patients and overcome challenges related to the changed communication context, including video demonstrations, telehealth communication tips, and step-by-step approaches to identifying high-risk patients and documenting conversation findings in the electronic health record. Well-designed communication tools and implementation strategies can equip clinicians to foster connection with patients and promote shared decision making. Although not an antidote to this crisis, such high-quality ACP may be one of the most powerful tools we have to prevent or ameliorate suffering due to COVID-19. |
| Databáze: | OpenAIRE |
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