A5071591407- Palliative Care and End-of-Life Issues
- Patient Dignity and Privacy
- Patient-Provider Communication in Healthcare
- Childhood Cancer Survivors' Quality of Life
- Family and Patient Care in Intensive Care Units
- Cancer survivorship and care
- Mental Health and Patient Involvement
- Occupational Health and Safety Research
- Health Systems, Economic Evaluations, Quality of Life
- Economic and Financial Impacts of Cancer
- Ethics in medical practice
- Pancreatic and Hepatic Oncology Research
- Healthcare cost, quality, practices
- Focus Groups and Qualitative Methods
- Primary Care and Health Outcomes
- Pain Management and Opioid Use
- Advanced X-ray and CT Imaging
- Clinical practice guidelines implementation
- Health Policy Implementation Science
- Opioid Use Disorder Treatment
- Innovative Approaches in Technology and Social Development
- Health Sciences Research and Education
- Medical Malpractice and Liability Issues
- Interprofessional Education and Collaboration
- Health Literacy and Information Accessibility
Dartmouth College
2016-2025
Dartmouth–Hitchcock Medical Center
2013-2024
Dartmouth Health
2024
Dartmouth Psychiatric Research Center
2024
Wilson Community College
2023
Dartmouth Institute for Health Policy and Clinical Practice
2022
Northwestern Memorial Hospital
2012
Importance Numerous studies show that early palliative care improves quality of life and other key outcomes in patients with advanced cancer their caregivers, although most lack access to this evidence-based model care. Objective To evaluate whether delivering via secure video vs in-person visits has an equivalent effect on non–small cell lung (NSCLC). Design, Setting, Participants Randomized, multisite, comparative effectiveness trial from June 14, 2018, May 4, 2023, at 22 US centers among...
Background Care partners of people with serious illness experience significant challenges and unmet needs during the patient’s treatment period after their death. Learning from others shared experiences can be valuable, but opportunities are not consistently available. Objective This study aims to design prototype a regional, facilitated, web-based peer support network help active bereaved care persons better prepared cope surprises that arise in bereavement. Methods An 18-member co-design...
Background: To provide patient-centered healthcare for people with serious illness, teams must elicit needs, goals, preferences, and values from patients care partners. Aim: Describe feasibility acceptability of an electronic pre-visit agenda-setting questionnaire partners to identify these topics before ambulatory palliative visits. Design: Concurrent mixed-methods formative evaluation acceptability. We extracted responses patient characteristics health records sent anonymous post-visit...
Professional societies have called for methods to improve serious illness communication training critical care fellows and faculty. The Serious Illness Conversation Guide (SICG) is a best practice tool discussing goals of in an outpatient setting. Suitability SICG tailored the intensive unit (ICU) setting impact on behaviors clinicians. In 460-bed rural academic medical center, 12 service (CCS) 8 CCS faculty received one-day palliative led ICU context including early late discussions. A...
Background: Improving access to palliative care is an important priority for hospitals as they strive provide the best and quality of life their patients. Even in with longstanding programs, only a small proportion patients life-threatening illnesses receive services. Our two well-established programs large academic used innovative improvement initiative broaden services, particularly noncancer Methods: The utilized combination electronic manual screening medical records well intensive...
Introduction: Advance care planning (ACP), a critical component of quality dementia care, is underutilized due to lack clinician comfort and the challenging nature ACP in this context. The Serious Illness Conversation Guide (SICG) well-validated clinician-facing tool, developed with patient input, facilitate ACP. aim project was adapt SICG for first time promote high-quality Methods: This study uses mixed-methods approach tool use care. Experts relevant clinical, ethical, topical knowledge...
Improving communication training for primary palliative care using a required rotation internal medicine (IM) residents has not been assessed.To assess skills acquisition and acceptability IM selecting an elective.A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of experience, finally post-OSCE to crystallize take home points.IM second year from Dartmouth-Hitchcock were exposed experiential rotation.Pre-...
The coproduction learning health system (CLHS) model extends the definition of a to explicitly bring together patients and care partners, teams, administrators, scientists share work optimizing outcomes, improving value, generating new knowledge. CLHS highlights partnership for that is supported by data can be used support individual patient care, quality improvement, research. We provide case study describes application this transform within an oncology program at academic medical center.
Background Gaps in communication of end-of-life care preferences increase risk patient harm. Adoption oncology practice guidelines advocating serious illness for patients with advanced cancer is limited. Objectives (1) Increase Serious Illness Conversation (SIC) use across teams via an interdisciplinary quality improvement (QI) approach and (2) assess reported shared decision making (SDM) experiences clinicians engaged SIC implementation. Design QI methodology was applied to spread the...
We aimed to increase Serious Illness Conversations (SIC) from a baseline of, at or near, zero 25% of eligible patients by December 31, 2020.We assembled an interdisciplinary team inclusive family partner and used the Model for Improvement as our quality improvement framework. The developed SMART Aim, key driver diagram, SIC workflow. Standardized screening eligibility was implemented using 2-year surprise question. Team members were trained in communication skills facilitator received...
Background: Funding and limited resources are barriers to required training of residents in serious illness conversation (SIC) skills. Objectives: To examine the effectiveness a low-cost, low-resource (LCLR) SIC embedded within palliative care rotation. Design: Pre–post prospective cohort study design. Setting/Subjects: Second year internal medicine (IM) received an LCLR three-hour Guide (SICG) with single-faculty member paired-participant practice replacing actors during two-week Measures:...
Despite progress in developing learning health systems (LHS) and associated metrics of success, a gap remains identifying measures to guide the implementation assessment impact an oncology LHS. Our aim was identify balanced set person-centered LHS.A modified Delphi process clinical value compass framework were used prioritize for tracking LHS performance. A multidisciplinary group 77 stakeholders, including people with cancer family members, participated 3 rounds online voting followed by...