Overview
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 decision aid until thematic saturation is reached and it is ready for testing in a clinical trial.
Eligibility
- Inclusion
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- 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
- 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.