Implementing Automated Triggers to Identify Hospitalized Patients with Possible Unmet Palliative Needs : Assessing the Impact of This Systems Approach on Clinicians
(2020) In Journal of Palliative Medicine 23(11). p.1500-1506- Abstract
Background: Understanding patients' goals and values is important to ensure goal-concordant care; however, such discussions can be challenging. Little is known about the impact of having these discussions on hospitalists. Objective: To assess the impact on hospitalists of a system that reminds them to have serious illness conversations with their patients identified with potential unmet palliative needs. Design: Two group cohort trial. Setting/Subjects: Single academic center. Internal medicine hospitalist physicians, nurse practitioners, and physician's assistants. Measurements: Before the trial, all participants received serious illness conversation training. During the trial, hospitalists on intervention units received verbal... (More)
Background: Understanding patients' goals and values is important to ensure goal-concordant care; however, such discussions can be challenging. Little is known about the impact of having these discussions on hospitalists. Objective: To assess the impact on hospitalists of a system that reminds them to have serious illness conversations with their patients identified with potential unmet palliative needs. Design: Two group cohort trial. Setting/Subjects: Single academic center. Internal medicine hospitalist physicians, nurse practitioners, and physician's assistants. Measurements: Before the trial, all participants received serious illness conversation training. During the trial, hospitalists on intervention units received verbal notification when their recently admitted patients were identified using a computer algorithm as having possible unmet palliative needs. Hospitalists on the control unit received no notifications. At baseline and three months, hospitalists completed questionnaires regarding communication skill acquisition, perception of the importance of these conversations, and sense of the meaning gained from having them. Results: Both groups had similar improvements in their self-reported communication skills and experienced a small decline in how important they felt the conversations were. Neither group perceived having the discussions as being affectively harmful to patients. The intervention hospitalists, over time, reported a slight reduction in the sense of meaning they achieved from the conversations. Conclusion: Routinely informing hospitalists when their patients were identified as being at increased risk for unmet palliative needs did not increase the sense of meaning these providers achieved. It is likely the pretrial training accounted for many of the positive outcomes in communication skills observed in both arms of the trial.
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- author
- Greenwald, Jeffrey L ; Greer, Joseph A ; Gace, Denisa ; Sommer, Robert K ; Daubman, Bethany-Rose ; Rosenberg, Leah B ; LaSala, Cynthia and Jacobsen, Juliet LU
- publishing date
- 2020-11
- type
- Contribution to journal
- publication status
- published
- keywords
- Communication, Hospitalists, Humans, Palliative Care, Patients, Systems Analysis
- in
- Journal of Palliative Medicine
- volume
- 23
- issue
- 11
- pages
- 1500 - 1506
- publisher
- Mary Ann Liebert, Inc.
- external identifiers
-
- scopus:85096112908
- pmid:32589501
- ISSN
- 1096-6218
- DOI
- 10.1089/jpm.2020.0161
- language
- English
- LU publication?
- no
- id
- c17487d9-c475-4856-8dd3-ceca71e2783d
- date added to LUP
- 2024-09-18 08:03:58
- date last changed
- 2024-10-03 06:37:02
@article{c17487d9-c475-4856-8dd3-ceca71e2783d,
abstract = {{<p>Background: Understanding patients' goals and values is important to ensure goal-concordant care; however, such discussions can be challenging. Little is known about the impact of having these discussions on hospitalists. Objective: To assess the impact on hospitalists of a system that reminds them to have serious illness conversations with their patients identified with potential unmet palliative needs. Design: Two group cohort trial. Setting/Subjects: Single academic center. Internal medicine hospitalist physicians, nurse practitioners, and physician's assistants. Measurements: Before the trial, all participants received serious illness conversation training. During the trial, hospitalists on intervention units received verbal notification when their recently admitted patients were identified using a computer algorithm as having possible unmet palliative needs. Hospitalists on the control unit received no notifications. At baseline and three months, hospitalists completed questionnaires regarding communication skill acquisition, perception of the importance of these conversations, and sense of the meaning gained from having them. Results: Both groups had similar improvements in their self-reported communication skills and experienced a small decline in how important they felt the conversations were. Neither group perceived having the discussions as being affectively harmful to patients. The intervention hospitalists, over time, reported a slight reduction in the sense of meaning they achieved from the conversations. Conclusion: Routinely informing hospitalists when their patients were identified as being at increased risk for unmet palliative needs did not increase the sense of meaning these providers achieved. It is likely the pretrial training accounted for many of the positive outcomes in communication skills observed in both arms of the trial.</p>}},
author = {{Greenwald, Jeffrey L and Greer, Joseph A and Gace, Denisa and Sommer, Robert K and Daubman, Bethany-Rose and Rosenberg, Leah B and LaSala, Cynthia and Jacobsen, Juliet}},
issn = {{1096-6218}},
keywords = {{Communication; Hospitalists; Humans; Palliative Care; Patients; Systems Analysis}},
language = {{eng}},
number = {{11}},
pages = {{1500--1506}},
publisher = {{Mary Ann Liebert, Inc.}},
series = {{Journal of Palliative Medicine}},
title = {{Implementing Automated Triggers to Identify Hospitalized Patients with Possible Unmet Palliative Needs : Assessing the Impact of This Systems Approach on Clinicians}},
url = {{http://dx.doi.org/10.1089/jpm.2020.0161}},
doi = {{10.1089/jpm.2020.0161}},
volume = {{23}},
year = {{2020}},
}