The following is a summary of “Using Design Thinking to Promote Goals of Care Conversations With Seriously Ill Patients,” published in the August 2023 issue of Pain and Symptom Management by Casarett et al.

Conversations regarding goals of care (GOC) can potentially enhance outcomes related to severe illness, including managing pain and symptoms and patient satisfaction. However, it has been observed that a minimal number of deceased patients at Duke Health had a Goals of Care (GOC) conversation recorded in the designated electronic health record (EHR) section. Hence, in the year 2020, researchers established a goal that all patients under the care of Duke Health who passed away should have undergone a Goals of Care (GOC) conversation, with the details of the discussion recorded in a dedicated Electronic Health Record (EHR) section within the final six months preceding their demise.

Investigators employed two intertwined methodologies to formulate a medical plan to enhance GOC (Goals of Care) discussions. The initial model discussed is RE-AIM, a framework utilized to design, report, and evaluate research about health behavior. The second approach was not so much a model as a medical approach to addressing problems, referred to as “design thinking.” 

Both of these methodologies were implemented in a comprehensive initiative that resulted in a 50% incidence rate of Goals of Care (GOC) discussions during the final six months before death. When implemented together, essential interventions can substantially influence behavior modification within an academic health system. Researchers discovered that implementing design thinking techniques provided a valuable connection between the RE-AIM strategy and clinical practices.

Source: sciencedirect.com/science/article/abs/pii/S0885392423004645