Using Design Thinking to Promote Goals of Care Conversations With Seriously Ill Patients

Background. Goals of care (GOC) conversations can improve serious illness outcomes such as pain and symptom manage-ment and patient satisfaction.Problem. However, we recognized that very few Duke Health patients who died had a GOC conversation documented in the designated electronic health record (EHR) tab. Therefore, in 2020, we set a target that all Duke Health patients who died should have had a GOC conversation documented in a designated EHR tab in the last 6 months of life.Intervention. In developing a strategy to promote GOC conversations, we used two interwoven approaches. The first was RE -AIM, a model for designing, reporting and evaluating health behavior research. The second was less of a model than a way of approaching problems, known as "design thinking."Outcomes. We employed both of these approaches in a system-wide effort that achieved a 50% prevalence of GOC conversa-tions in the last 6 months of life.Key message. In combination, simple interventions can have a significant impact on behavior change in an academic health system. Lessons learned. We found that design thinking techniques offered a useful bridge between RE-AIM strategy and clinical J Pain Symptom Manage 2023;66:e275-e281.& COPY; 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.