Kelly McCutcheon Adams, LICSW
Two years ago at a medical appointment, the medical
assistant asked me if I have any medication reactions.
This was different than asking at prior appointments about medication allergies,
so I gave a different answer: yes, my brain gets nutty if I take cough syrup
with guaifenesin in it.
Since that day, every time I show up at a medical appointment
at any doctor’s office in my community, at the walk-in clinic or at the
emergency department, a conversation ensues about my mental status changes when
taking guaifenesin. One might think from the high reliability and seriousness
of these conversations that this is the single most important thing there is to
know about me. I might argue that it is the least important in the grand scheme,
but, nonetheless, reliable human and IT systems have been constructed to ensure
that this information is both available to my providers and that it is part of
their process to review it.
In contrast, the systems in most health care settings to
track information about what is most important to patients for their providers
to know about their wishes regarding end-of-life care are disconnected and
unreliable. The notion of reliably receiving,
recording, and respecting this information has been the focus for the last nine
months of the Institute for Healthcare Improvement’s “Conversation Ready” initiative.
Early Tests of the
I have had the pleasure of helping lead this work with our
nine dedicated Pioneer Sponsor organizations, who have been testing and
refining the ideas of what it means to be Conversation Ready. The
work of the Pioneer Sponsors is highlighted this month in a piece in Healthcare Executive and we are
happy to be able to share it with you.