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Pilot Study to Improve Goals of Care Conversations Among Hospitalists.

Publication ,  Journal Article
Pollak, KI; Gao, X; Beliveau, J; Griffith, B; Kennedy, D; Casarett, D
Published in: J Pain Symptom Manage
November 2019

CONTEXT: Many hospitalized patients receive care that is not concordant with their goals. Teaching communication skills that better align goals and treatment can improve the care that patients receive. OBJECTIVE: To develop and test an innovative approach that encourages hospitalists to engage in goals of care (GOC) conversations with their patients. METHODS: We recruited 14 hospitalists and randomized half to receive electronic health record alerts for patients who might benefit most from a goals-of-care conversation, as well as communication coaching. The coaching required an initial meeting, then audio recording of two GOC conversations and feedback from the coach. Outcomes were the presence of GOC conversations (primary), the quality of the GOC conversations, physician perceptions of the intervention, and hospital metrics (e.g., 30-day readmissions, referrals to palliative care). RESULTS: We did not increase the frequency of GOC conversations but did improve the quality of the conversations. Patients of physicians who received the intervention had fewer 30-day readmission rates and were less likely to die 90 days after admission than patients of physicians in the control arm. Patients of intervention physicians also had fewer palliative care consults than patients of control physicians. CONCLUSIONS: Teaching hospitalists to have GOC conversations translated into better skills and outcomes for patients. This pilot study shows promise and should be tested in a larger trial.

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Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

November 2019

Volume

58

Issue

5

Start / End Page

864 / 870

Location

United States

Related Subject Headings

  • Pilot Projects
  • Physician-Patient Relations
  • Patient Care Planning
  • Middle Aged
  • Male
  • Humans
  • Hospitalists
  • Female
  • Communication
  • Attitude of Health Personnel
 

Citation

APA
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ICMJE
MLA
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Pollak, K. I., Gao, X., Beliveau, J., Griffith, B., Kennedy, D., & Casarett, D. (2019). Pilot Study to Improve Goals of Care Conversations Among Hospitalists. J Pain Symptom Manage, 58(5), 864–870. https://doi.org/10.1016/j.jpainsymman.2019.06.007
Pollak, Kathryn I., Xiaomei Gao, Jessica Beliveau, Brian Griffith, Danielle Kennedy, and David Casarett. “Pilot Study to Improve Goals of Care Conversations Among Hospitalists.J Pain Symptom Manage 58, no. 5 (November 2019): 864–70. https://doi.org/10.1016/j.jpainsymman.2019.06.007.
Pollak KI, Gao X, Beliveau J, Griffith B, Kennedy D, Casarett D. Pilot Study to Improve Goals of Care Conversations Among Hospitalists. J Pain Symptom Manage. 2019 Nov;58(5):864–70.
Pollak, Kathryn I., et al. “Pilot Study to Improve Goals of Care Conversations Among Hospitalists.J Pain Symptom Manage, vol. 58, no. 5, Nov. 2019, pp. 864–70. Pubmed, doi:10.1016/j.jpainsymman.2019.06.007.
Pollak KI, Gao X, Beliveau J, Griffith B, Kennedy D, Casarett D. Pilot Study to Improve Goals of Care Conversations Among Hospitalists. J Pain Symptom Manage. 2019 Nov;58(5):864–870.
Journal cover image

Published In

J Pain Symptom Manage

DOI

EISSN

1873-6513

Publication Date

November 2019

Volume

58

Issue

5

Start / End Page

864 / 870

Location

United States

Related Subject Headings

  • Pilot Projects
  • Physician-Patient Relations
  • Patient Care Planning
  • Middle Aged
  • Male
  • Humans
  • Hospitalists
  • Female
  • Communication
  • Attitude of Health Personnel