دورية أكاديمية
Impact of Implementing Serious Illness Conversations Across a Comprehensive Cancer Center Using an Interdisciplinary Approach.
| العنوان: | Impact of Implementing Serious Illness Conversations Across a Comprehensive Cancer Center Using an Interdisciplinary Approach. |
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| المؤلفون: | Guo K; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA., Wasp G; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.; Section of Oncology, Department of Medicine, Dartmouth-Hitchcock Medical Center (DHMC), Lebanon, NH, USA.; Dartmouth Cancer Center, Lebanon, NH, USA.; Geisel School of Medicine at Dartmouth, Hanover, NH, USA., Vergo M; Geisel School of Medicine at Dartmouth, Hanover, NH, USA., Wilson M; Geisel School of Medicine at Dartmouth, Hanover, NH, USA., Holthoff MM; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA., Buus-Frank ME; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.; Section of Neonatology, Department of Pediatrics, The Children's Hospital at Dartmouth, Lebanon, NH, USA., Perry JJ; Department of Operational Excellence, DHMC, Lebanon, NH, USA., Cullinan AM; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.; Section of Palliative Care, Department of Medicine, DHMC, Lebanon, NH, USA. |
| المصدر: | The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2024 May 10, pp. 10499091241252058. Date of Electronic Publication: 2024 May 10. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Sage Publications Country of Publication: United States NLM ID: 9008229 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1938-2715 (Electronic) Linking ISSN: 10499091 NLM ISO Abbreviation: Am J Hosp Palliat Care Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Thousand Oaks, Calif. : Sage Publications Original Publication: Weston, MA : Prime National Pub. Corp., c1990- |
| مستخلص: | Background: Gaps in communication of end-of-life care preferences increase risk of patient harm. Adoption of oncology practice guidelines advocating serious illness communication for patients with advanced cancer is limited. Objectives: (1) Increase Serious Illness Conversation (SIC) use across oncology teams via an interdisciplinary quality improvement (QI) approach and (2) assess patient reported shared decision making (SDM) experiences with clinicians engaged in SIC implementation. Design: QI methodology was applied to spread the implementation of SIC across 4 oncology teams. CollaboRATE scores were used to evaluate patient reported outcomes of SDM for patients with advanced cancer. Settings/subjects: The SIC QI initiative was a component of the Promise Partnership Learning Health System (PPLHS) piloted in the Dartmouth Cancer Center, Lebanon, NH, USA. Measurements: (1) The percentage of eligible patients with documented SIC and (2) a comparison of a patient reported measure of SDM (CollaboRATE) among SIC eligible patients in encounters with providers who took part in the implementation versus those who did not. Results: Oncology teams screened a total of 538 patients, identified 278 eligible patients, and completed 144 SIC conversations. The teams improved the proportion of documented SIC among eligible patients from near 0% to a collective frequency of 52%. For clinicians' top-box CollaboRATE scores, a chi-squared test demonstrated a statistically significant association between providers implementing SIC into practice and patient reported shared decision making (.16, p = .031). Conclusions: This approach allows for tailoring of iterative improvement cycles to mitigate barriers and improve the practice of SIC among oncology teams. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. |
| فهرسة مساهمة: | Keywords: advance care planning; advanced cancer; palliative care; patient family adviser; quality improvement; serious illness conversation; shared decision making |
| تواريخ الأحداث: | Date Created: 20240510 Latest Revision: 20240510 |
| رمز التحديث: | 20240510 |
| DOI: | 10.1177/10499091241252058 |
| PMID: | 38725412 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1938-2715 |
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| DOI: | 10.1177/10499091241252058 |