iDECIDE: improving DECIsion‐making about goals of care for hospitalized, elDerly patiEnts / Funding:
$504,246
The overall objective of our program of research is to improve end‐of‐life (EOL) communication and decision‐making for seriously ill, hospitalized elderly patients. By improving communication and decision‐making near or at the EOL, we have the opportunity to dramatically improve the patients’ and families’ experience as they journey through the final days, improve the work experience for health care professionals, and avoid unwanted aggressive medical care at the EOL.
In our previous CIHR and partner‐funded research, we identified key barriers to EOL communication and decision‐making. Informed by this work, we have assembled a multifaceted bundle of interventions that aims to reduce these barriers: (1) a suite of web‐ and video‐based decision support tools to prepare patients and families to make decisions about their care near EOL, and (2) a coaching and team‐building program to increase healthcare providers’ EOL communication skills and build capacity to engage patients and families in goals of care discussions in an inter‐professional, team‐based manner.
The objective of this study is to engage 3 ‘incubator units’ across Canada (Ward of the 21st Century in Calgary, Hamilton Health Sciences, and McGill University Health Centre) to pilot test and refine the tools in this bundle before moving to wide scale dissemination and evaluation of these knowledge products.
Principal Investigator:
John You, MD, MSc, FRCPC / Host Institution:
McMaster University
/ John You is a hospital-based general internist who is a staff physician with Hamilton Health Sciences and an Associate Professor in the Departments of Medicine, and of Clinical Epidemiology & Biostatistics at McMaster University. He is also a member of the CLARITY (Clinical Advances Through Research and Information Translation) research group at McMaster and an executive member of CARENET (Canadian Researchers at the End-of-Life Network), an interdisciplinary network of health care professionals from across Canada who collaborate to improve palliative and end-of-life care. Dr. You received his BSc from McMaster University, and his MD and an MSc in Clinical Epidemiology from the University of Toronto. His primary clinical and scholarly interests are in improving the quality of end of life communication, decision-making, and care for seriously ill elderly patients and their families.
Principal Investigator:
Daren Heyland, MD, MSc, FRCPC / Host Institution:
Queen’s University
/ Daren Heyland is a Professor of Medicine at Queenʹs University, with a cross-appointment with the Department of Community Health and Epidemiology. He is also an Intensive Care Unit Staff Physician with the Kingston General Hospital (KGH), and Director of the Clinical Evaluation Research Unit, an academic research organization that conducts multi-centre studies based at KGH. Dr. Heyland completed his undergraduate and medical degrees at the University of Alberta, and his MSc at McMaster University. His research interests include: Nutritional therapy and gastrointestinal structure and function in the context of critical illness; pneumonia, sepsis, and other infections in the critically ill patient; economic evaluations, quality of life assessments and evidence‐based medicine; and end-of-life care, aging, patient preferences, and clinical decision‐making.
This research is funded by TVN (Technology Evaluation in the Elderly Network), which is supported by the Government of Canada through the Networks of Centres of Excellence (NCE) program. ™ Trademark of TVN. ©TVN, 2013-14. CORE2013-30 (2014 08).
Principal Investigator:Dev Jayaraman, MD, MPH / Host Institution:
The Research Institute of the McGill University Health Centre
/ Dev Jayaraman is an Associate Professor in the Departments of Medicine and Critical Care at McGill University. He is also the Director of Quality Improvement in both departments and Director of one of the clinical teaching units in the Division of General Internal Medicine. His major research interest is in improving the quality of care provided to in-patients on the medical wards and critical care units, particularly end of life care.
Principal Investigator:
Jessica Simon, MBChB, FRCPC / Host Institution:
University of Calgary
/ Jessica Simon is Physician Consultant for Advance Care Planning and Goals of Care (Calgary Zone) with Alberta Health Services, and Clinical Assistant Professor and Interim Division Head with the Division of Palliative Medicine, University of Calgary. A specialist in Internal Medicine, her clinical work is as a palliative consultant at the Foothills Medical Centre in Calgary. Before training in palliative medicine she completed clinical research fellowships in dementia and stroke medicine. She is a member of the Canadian Researchers at End-of-Life Network (CARENET), and her research interests are in advance care planning and the care of people living with advanced chronic disease.
Co-Investigators:
Peter Sargious, MD, MPH, University of Calgary
Laurence Green, MD, McGill University
Andrea Frolic, PhD, Hamilton Health Sciences
Rebecca Sudore, MD, University of California
Dr. Nishan Sharma, MSc, EdD, University of Calgary
Tasnim Sinuff, MD, PhD, University of Toronto/Sunnybrook Health Sciences Centre
Sharon Straus, MD, MSc, HBSc, University of Toronto/Li Ka Shing Knowledge Institute of St. Michael’s Hospital / Andrew Day, MSc, Clinical Evaluation Research Unit, Kingston General Hospital
Robert Fowler, MDCM, MSc, Sunnybrook Health Sciences Centre, University of Toronto
Peter Dodek, MD, MHSc, University of British Columbia
Jeff Myers, MD, MSEd, Sunnybrook Health Sciences Centre/University of Toronto
Project Contact: Project Leader –
This research is funded by TVN (Technology Evaluation in the Elderly Network), which is supported by the Government of Canada through the Networks of Centres of Excellence (NCE) program. ™ Trademark of TVN. ©TVN, 2013-14. CORE2013-30 (2014 08).