Strategies for effective goals of care discussions and decision-making: perspectives from a multi-centre survey of Canadian hospital-based healthcare providersReport as inadecuate




Strategies for effective goals of care discussions and decision-making: perspectives from a multi-centre survey of Canadian hospital-based healthcare providers - Download this document for free, or read online. Document in PDF available to download.

BMC Palliative Care

, 14:38

First Online: 19 August 2015Received: 06 December 2014Accepted: 10 August 2015

Abstract

BackgroundCommunication gaps impact the quality of patient care. Previous research has focused on communication barriers rather than seeking solutions. Our aim was to identify strategies for effective communication and decision-making about goals of care for medical interventions in serious illness, from the perspectives of hospital-based healthcare providers.

MethodsA cross-sectional survey composed of closed- and open-ended questions about goals of care communication and decision-making was administered to healthcare providers in 13 centres in six Canadian provinces. We analyzed a portion of the open-ended survey questions, specifically 1 suggestions for overcoming barriers encountered in discussing goals of care, and 2 currently effective practices. Thematic content analysis was used to analyze responses to the open-ended questions.

ResultsOf the 1,256 respondents to the larger survey, 468 responded to the open-ended questions 37 %, including 272 of 512 nurses 53 %, 153 of 484 internal medicine trainees 32 %, and 43 of 260 attending physicians 17 %. Responses to each of the two questions were similar, generating a common set of themes and subthemes. Effective strategies and ideas for improving communication and decision-making about goals of care clustered under five themes: patient and family factors, communication between healthcare providers and patients, interprofessional collaboration, education, and resources. Subthemes highlighted core elements of shared decision-making.

ConclusionsTranslating our findings into multifaceted interventions that consider patient and family factors, address knowledge gaps, optimize resource utilization, and facilitate communication and collaboration between patients, families and healthcare providers may improve communication and decision-making about goals of care.

AbbreviationsACCEPTAudit of Communication, CarE Planning, and DocumenTation

EOLEnd of life

MTUMedical teaching unit

GOCGoals of care

QOLQuality of life

PGYPostgraduate year

Electronic supplementary materialThe online version of this article doi:10.1186-s12904-015-0035-x contains supplementary material, which is available to authorized users.

Download fulltext PDF



Author: Amanda L. Roze des Ordons - Nishan Sharma - Daren K. Heyland - John J. You

Source: https://link.springer.com/



DOWNLOAD PDF




Related documents