Explanipedia

Clinical Momentum Open

Melanie Fritz, Michael A. Jaeb, Sarah I. Zaza, Alex Dudek, Kristine L. Kwekkeboom , et al. · 2025

Objective: We evaluated the empirical fit of our model of clinical momentum for older adults with life-limiting illness undergoing unplanned surgery. Background: Older adults often undergo surgery near the end of life, in contrast to gener…

Clinical momentum in the care of older adults with advanced dementia: What evidence is there in the medical record? Open

Lily Stalter, Bret M. Hanlon, Kyle J. Bushaw, Taylor Bradley, Anne Buffington , et al. · 2024

Best Case/Worst Case-ICU: protocol for a multisite, stepped-wedge, randomised clinical trial of scenario planning to improve communication in the ICU in US trauma centres for older adults with serious injury Open

Lily Stalter, Bret M. Hanlon, Kyle J. Bushaw, Kristine L. Kwekkeboom, Amy Zelenski , et al. · 2024

Introduction Poor communication about serious injury in older adults can lead to treatment that is inconsistent with patient preferences, create conflict and strain healthcare resources. We developed a communication intervention called Bes…

Systems Forces Leading to Feeding Tube Placement in Patients with Advanced Dementia: A Qualitative Exploration of Clinical Momentum Open

Sarah I. Zaza, Nora Jacobson, Anne Buffington, Alex Dudek, Karlie Haug , et al. · 2024

Background: Older adults with serious illness near the end-of-life often receive invasive treatments. We developed a conceptual model called clinical momentum that describes system-level forces producing a trajectory of care …

Embedding an Education Intervention about Shared Decision Making into an RCT: Ensuring competency and fidelity Open

Amy Zelenski, Karlie Haug, Kyle J. Bushaw, Anne Buffington, Taylor Bradley , et al. · 2024

Best Case/Worst Case: protocol for a multisite randomised clinical trial of a scenario planning intervention for patients with kidney failure Open

Karlie Haug, Anne Buffington, Amy Zelenski, Bret M. Hanlon, Lily Stalter , et al. · 2022

Introduction Given the burdens of treatment and poor prognosis, older adults with kidney failure would benefit from improved decision making and palliative care to clarify goals, address symptoms, and reduce unwanted procedures. Best Case/…

Impact of Care Coordination on the Content of Communication Between Surgeons and Patients With Rectal Cancer Open

Elise H. Lawson, Joshua Sommovilla, Anne Buffington, Amy Zelenski, Margaret L. Schwarze · 2022

Background: Management of patients with rectal cancer can be complex, requiring significant care coordination and decisions that balance functional and oncologic outcomes. Objective: To characterize care coordination occurring during surgi…

Surgeon Use of Shared Decision-making for Older Adults Considering Major Surgery Open

Nathan D. Baggett, Kathryn Schulz, Anne Buffington, Nicholas Marka, Bret M. Hanlon , et al. · 2022

ClinicalTrials.gov Identifier: NCT02623335.

Expressions of conflict following postoperative complications in older adults having major surgery Open

Elle L. Kalbfell, Anne Buffington, Anna Kata, Karen J. Brasel, Anne C. Mosenthal , et al. · 2021

Best case/worst case for the trauma ICU: Development and pilot testing of a communication tool for older adults with traumatic injury Open

Christopher J. Zimmermann, Amy Zelenski, Anne Buffington, Nathan D. Baggett, Jennifer L. Tucholka , et al. · 2021

BACKGROUND “Best Case/Worst Case” (BC/WC) is a communication tool to support shared decision making in older adults with surgical illness. We aimed to adapt and test BC/WC for use with critically ill older adult trauma patients. METHODS We…

Frequency of Preoperative Advance Care Planning for Older Adults Undergoing High-risk Surgery Open

Elle L. Kalbfell, Anna Kata, Anne Buffington, Nicholas Marka, Karen J. Brasel , et al. · 2021

IMPORTANCE: For patients facing major surgery, surgeons believe preoperative advance care planning (ACP) is valuable and routinely performed. How often preoperative ACP occurs is unknown. OBJECTIVE: To quantify the frequency of preoperativ…

The Association Between Factors Promoting Nonbeneficial Surgery and Moral Distress Open

Christopher J. Zimmermann, Lauren J. Taylor, Jennifer L. Tucholka, Anne Buffington, Karen J. Brasel , et al. · 2020

Objective: To assess the prevalence of moral distress among surgeons and test the association between factors promoting non-beneficial surgery and surgeons’ moral distress. Summary Background Data: Moral distress experienced by clinicians …

Testing Whether Providing Older Patients with a List of Questions to Ask Their Surgeons Improves Decision Making and Well-Being Open

Margaret L. Schwarze, Anne Buffington, Jennifer L. Tucholka, Bret M. Hanlon, Paul J. Rathouz , et al. · 2020

Opportunities to Improve Shared Decision Making in Dialysis Decisions for Older Adults with Life-Limiting Kidney Disease: A Pilot Study Open

Christopher J. Zimmermann, R. Allan Jhagroo, Maureen Wakeen, Kathryn Schueller, Amy Zelenski , et al. · 2020

Background: Lack of awareness about the life-limiting nature of renal failure is a significant barrier to palliative care for older adults with end-stage renal disease. Objective: To train nephrologists to use t…

UsinCommunity Engagement Approaches to Bolster 2020 Census Participation Open

John J. Green, Heather Hanna, Lynn L. Woo, Rachel Haggard, Anne Buffington · 2020

Census data are used for numerous decision-making processes, many of which impact children. From a project in Mississippi, this article reports on use of public data to identify places where children might be undercounted and use of commun…

Effectiveness of a Question Prompt List Intervention for Older Patients Considering Major Surgery Open

Margaret L. Schwarze, Anne Buffington, Jennifer L. Tucholka, Bret M. Hanlon, Paul J. Rathouz , et al. · 2019

ClinicalTrials.gov identifier: NCT02623335.

Family and transplant professionals’ views of organ recovery before circulatory death for imminently dying patients: A qualitative study using semistructured interviews and focus groups Open

Christopher J. Zimmermann, Nathan D. Baggett, Lauren J. Taylor, Anne Buffington, Joseph R. Scalea , et al. · 2019

Harms of unsuccessful donation after circulatory death: An exploratory study Open

Lauren J. Taylor, Anne Buffington, Joseph R. Scalea, Norman Fost, Kenneth D. Croes , et al. · 2017

While donation after circulatory death (DCD) has expanded options for organ donation, many who wish to donate are still unable to do so. We conducted face-to-face interviews with family members (N = 15) who had direct experience with unsuc…

Navigating high-risk surgery: protocol for a multisite, stepped wedge, cluster-randomised trial of a question prompt list intervention to empower older adults to ask questions that inform treatment decisions Open

Lauren J. Taylor, Paul J. Rathouz, Ana Berlin, Karen J. Brasel, Anne C. Mosenthal , et al. · 2017

Introduction Older patients frequently undergo operations that carry high risk for postoperative complications and death. Poor preoperative communication between patients and surgeons can lead to uninformed decisions and result in unexpect…

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