Emergency Department Physicians' Opinions on Goals of Care Discussions Revealed

Strategic Insights -

A recent qualitative study on emergency department (ED) physicians' opinions on leading goals of care discussions has provided valuable insights into the feasibility of implementing such discussions in the ED. The study, conducted by the Center for Research and published in the Canadian Journal of Emergency Medicine, explored the Normalization Process Theory to understand the factors influencing the implementation of goals of care discussions. The research involved semi-structured interviews with ten emergency physicians and identified 14 themes as factors influencing the feasibility of implementing goals of care discussions in the ED.

Key Takeaways:

  • The study found that goals of care discussions are possible and essential with selected ED patients, but physicians identified outstanding needs to normalize these discussions in their practice.
  • The needs include education for both physicians and patients on the concept of goals of care discussions, legislative action for systematization, and proactive documentation of patients' preferences pre-ED.
  • Clinician and system-level policy-making efforts are necessary to address these needs and ensure the normalization of goals of care discussions in emergency physicians' daily practice as suggested by clinical guidelines.
  • The study highlights the importance of interpersonal communication, efficiency of care, and the importance of goals of care during handover as key factors influencing the feasibility of implementing goals of care discussions in the ED.
  • The research suggests that proactive documentation of patients' preferences pre-ED is crucial for the normalization of goals of care discussions.

Statistics:

  • 14 themes were identified as factors influencing the feasibility of implementing goals of care discussions in the ED.
  • The study involved semi-structured interviews with 10 emergency physicians.
  • The research was based on the Normalization Process Theory and used a mixed deductive and inductive thematic analysis.

Sources:

  • Discussions about goals of care in the emergency department: a qualitative study of emergency physicians' opinions using the normalization process theory. Canadian Journal of Emergency Medicine, Canadian Journal of Emergency Medicine.
  • Center for Research intègre pour un système apprenant en santé et services sociaux, Centre intègre de santé et de services sociaux de Chaudière-Appalaches, Levis, QC, Canada.
  • Emile Marmen, Center for Research intègre pour un système apprenant en santé et services sociaux, Centre intègre de santé et de services sociaux de Chaudière-Appalaches, Levis, QC, Canada.
  • Springer Heidelberg, Tiergartenstrasse 17, D-69121 Heidelberg, Germany (publisher contact information for the Canadian Journal of Emergency Medicine).
  • NewsRx. Center for Research Reports Findings in Science (Discussions about goals of care in the emergency department: a qualitative study of emergency physicians' opinions using the normalization process theory). Education Letter. June 18, 2025; p 82.