Did a Goals-of-Care Discussion Happen? Differences in the Occurrence of Goals-of-Care Discussions as Reported by Patients, Clinicians, and in the Electronic Health Record
| Autor: | Erin K. Kross, J. Randall Curtis, Lois Downey, Matthew E. Modes, Elizabeth L. Nielsen, Ruth A. Engelberg |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Counseling Male medicine.medical_specialty Palliative care Quality management Patients Health Personnel Context (language use) Documentation Patient Care Planning Article 03 medical and health sciences 0302 clinical medicine Electronic health record Surveys and Questionnaires medicine Electronic Health Records Humans 030212 general & internal medicine General Nursing Reimbursement Aged Aged 80 and over Receipt Terminal Care business.industry Middle Aged Quality Improvement Anesthesiology and Pain Medicine 030220 oncology & carcinogenesis Family medicine Female Self Report Neurology (clinical) Patient report business |
| Zdroj: | Journal of Pain and Symptom Management. 57:251-259 |
| ISSN: | 0885-3924 |
| DOI: | 10.1016/j.jpainsymman.2018.10.507 |
| Popis: | CONTEXT: Goals-of-care discussions are associated with improved end-of-life care for patients and therefore may be used as a process measure in quality improvement, research, and reimbursement programs. OBJECTIVES: To examine three methods to assess occurrence of a goals-of-care discussion - patient report, clinician report, and documentation in the electronic health record (EHR) - at a clinic visit for seriously ill patients and determine whether each method is associated with patient-reported receipt of goal-concordant care. METHODS: Secondary analysis of a multi-center cluster-randomized trial, with 494 patients and 124 clinicians caring for them. Self-reported surveys collected from patients and clinicians two weeks after a clinic visit assessed occurrence of a goals-of-care discussion. Documentation of a goals-of-care discussion was abstracted from the EHR. Patient-reported receipt of goal-concordant care was assessed by survey two weeks after the visit. RESULTS: 52% of patients reported occurrence of a goals-of-care discussion at the clinic visit; clinicians reported occurrence of a discussion at 66% of visits. EHR documentation occurred in 42% of visits (p |
| Databáze: | OpenAIRE |
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