Kelly McCutcheon Adams, LICSW

Director, IHI

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.

More Important Conversations

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 Idea

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.