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Adapting the serious illness conversation guide for use in the emergency department by social workers

Published online by Cambridge University Press:  18 June 2021

Emily Loving Aaronson*
Affiliation:
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA Lawrence Center for Quality and Safety, Massachusetts General Hospital and Massachusetts General Physicians’ Organization, Boston, MA
Jeffrey L. Greenwald
Affiliation:
Core Educator Faculty, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
Lindsey R. Krenzel
Affiliation:
Department of Social Work, Massachusetts General Hospital, Harvard Medical School, Boston, MA
Angelina M. Rogers
Affiliation:
Department of Social Work, Massachusetts General Hospital, Harvard Medical School, Boston, MA
Lauren LaPointe
Affiliation:
Department of Social Work, Massachusetts General Hospital, Harvard Medical School, Boston, MA
Juliet C. Jacobsen
Affiliation:
Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
*Corresponding
Author for correspondence: Emily L. Aaronson, Lawrence Center for Quality and Safety, Massachusetts General Hospital, 55 Fruit St, Bulfinch Building, Suite 280, Boston, MA 02115, USA. E-mail: emily.aaronson@mgh.harvard.edu

Abstract

Objective

Although important treatment decisions are made in the Emergency Department (ED), conversations about patients’ goals and values and priorities often do not occur. There is a critical need to improve the frequency of these conversations, so that ED providers can align treatment plans with these goals, values, and priorities. The Serious Illness Conversation Guide has been used in other care settings and has been demonstrated to improve the frequency, quality, and timing of conversations, but it has not been used in the ED setting. Additionally, ED social workers, although integrated into hospital and home-based palliative care, have not been engaged in programs to advance serious illness conversations in the ED. We set out to adapt the Serious Illness Conversation Guide for use in the ED by social workers.

Methods

We undertook a four-phase process for the adaptation of the Serious Illness Conversation Guide for use in the ED by social workers. This included simulated testing exercises, pilot testing, and deployment with patients in the ED.

Results

During each phase of the Guide's adaptation, changes were made to reflect both the environment of care (ED) and the clinicians (social workers) that would be using the Guide. A final guide is presented.

Significance of results

This report presents an adapted Serious Illness Conversation Guide for use in the ED by social workers. This Guide may provide a tool that can be used to increase the frequency and quality of serious illness conversations in the ED.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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