| Phase: |
|
| Theme: | () |
| Status: | Active |
| Start Date: | 2015-11-01 |
| End Date: | 2015-11-01 |
| Project Leader |
| Downar, James |
Project Overview
Canadians prefer to avoid aggressive life-sustaining treatments at the end of life, but they often receive this care because their healthcare team failed to engage in Advance Care Planning (ACP) before they became seriously ill. It can be challenging to identify patients who are dying; even when accurate prognostic tools are available, clinicians often forget or are unwilling to use them and act on the result. If we had an accurate, automated, computer-based tool to identify patients with a limited prognosis, we could use this tool to trigger ACP and Palliative Care (PC) interventions more appropriately and reliably.
A recent Canadian study reported a highly accurate tool for predicting mortality using administrative data. With small changes, this tool could be used at the time of hospital admission to identify patients with a limited prognosis and send automatic notifications to remind the medical team to address ACP or PC needs. In this project, we will develop and implement this tool and evaluate it in a pilot study. We will study the accuracy of the tool, but we will focus on the impact of the tool on physicians, other healthcare practitioners, patients and family members. If we can successfully implement this tool in our pilot sites, it could be implemented at any hospital in North America and used to “trigger” any intervention appropriate for frail and seriously ill patients nearing the end of their life (e.g. ACP, PC consultation, Medication Deprescription, etc.), with the potential to dramatically improve their care.
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