Conversing with High-Risk Patients to Determine Serious Illness Goals and Values in the Time of Covid-19
- 17 February 2021
- journal article
- case report
- Published by Massachusetts Medical Society in NEJM Catalyst
- Vol. 2 (3)
- https://doi.org/10.1056/cat.20.0600
Abstract
During the Covid-19 pandemic’s first surge in Boston, Brigham Health sought to ensure that patients’ health care proxies and serious illness wishes were known to care teams. The authors engaged a diverse set of team members in outreach regarding serious illness conversations. Patients enrolled in the Integrated Care Management Program (iCMP) were contacted by their own nurse care coordinator for a serious illness conversation, discussing patients’ goals and values in the context of underlying illness and the threat of Covid-19. Simultaneously, nurses, medical students, and social care team members reached out to non-iCMP primary care patients identified as being at high risk of morbidity or mortality from Covid-19 and engaged these patients in conversations regarding health care proxy documentation and social determinants of health needs. The authors’ experience demonstrates that such a population health approach can facilitate timely and well-accepted outreach regarding serious illness to patients with varied needs and profiles.Keywords
This publication has 18 references indexed in Scilit:
- Using Nurse Care Managers Trained in the Serious Illness Conversation Guide to Increase Goals-of-Care Conversations in an Accountable Care OrganizationJournal of Palliative Medicine, 2020
- Development and Validation of a Deep Learning Algorithm for Mortality Prediction in Selecting Patients With Dementia for Earlier Palliative Care InterventionsJAMA Network Open, 2019
- Effect of the Serious Illness Care Program in Outpatient OncologyJAMA Internal Medicine, 2019
- Identifying the Population with Serious Illness: The “Denominator” ChallengeJournal of Palliative Medicine, 2018
- Bending The Spending Curve By Altering Care Delivery Patterns: The Role Of Care Management Within A Pioneer ACOHealth Affairs, 2017
- Clinician considerations when selecting high-risk patients for care management.2015
- The impact of advance care planning on end of life care in elderly patients: randomised controlled trialBMJ, 2010
- End-of-Life Discussions, Goal Attainment, and Distress at the End of Life: Predictors and Outcomes of Receipt of Care Consistent With PreferencesJournal of Clinical Oncology, 2010
- Health Care Costs in the Last Week of LifeArchives of Internal Medicine, 2009
- Associations Between End-of-Life Discussions, Patient Mental Health, Medical Care Near Death, and Caregiver Bereavement AdjustmentJAMA, 2008