A Communication Tool to Assist Severely Injured Older Adults

Summary

The purpose of this study is to test the effect of the "Best Case/Worse Case" (BC/WC) communication tool on the quality of communication with older patients admitted to two trauma units. The intervention was developed and tested with acute care surgical patients at the University of Wisconsin (UW) and we are now testing whether the intervention will work in a different setting. We will test the intervention with severely injured older adults at Oregon Health Sciences University (OHSU) and Parkland Memorial Hospital (PMH) at the University of Texas Southwestern (UTS). In the first year, UTS/PMH and OHSU will recruit and enroll 50 patients in the control arm (total, for both sites) and train trauma surgeons to use the best case/worst case tool. In the second year, UTS/PMH and OHSU will recruit and enroll 50 patients in the intervention arm (total, for both sites). UW will compare survey-reported and chart-derived measures before and after clinicians learn to use the best case/worst case tool.

Conditions

• Communication

Interventions

OTHER

Best Case/Worst Case communication tool

The communication tool promotes dialogue and patient deliberation, and supports shared decision making in the context of life-limiting illness. Building on a conceptual model of shared decision-making proposed and the practice of scenario planning our intervention is designed to lead to a discussion of patient preferences and consideration of outcomes. The surgeon verbally describes the "best case," "worst case," and "most likely" outcomes for each treatment option-incorporating rich narrative from clinical experience and translation of probabilistic information-while drawing a diagram of those options. The surgeon also writes details about each option on the diagram. The narrative and graphic help family and patients formulate and express preferences.

Sponsors & Collaborators

• National Institute on Aging (NIA)

  collaborator NIH

• Oregon Health and Science University

  collaborator OTHER

• University of Texas Southwestern Medical Center

  collaborator OTHER

• University of Wisconsin, Madison

  lead OTHER

Principal Investigators

• Gretchen Schwarze, MD, MPP, FACS · University of Wisconsin, Madison

• Karen Brasel, MD, MPH · Oregon Health and Science University

• Thomas Shoultz, MD · University of Texas Southwestern Medical Center

Study Design

Allocation

NON_RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2017-07-14

Primary Completion

2019-12-20

Completion

2020-03-03

Countries

• United States

Study Locations