GEAR 2.0 Priorities – Communications and Decision-Making

The key components of Emergency Department (ED) communication remain largely undefined, but existing research on ED communication in non-dementia populations demonstrates a suboptimal level of information exchange. Dementia may add layers of complexity to current ED communication strategies. This complexity must be addressed to ensure that patients and their care partners feel a part of the care process. Strategies employed by surgical medicine, particularly those that use patient values to drive patient-centered medicine practices, can be applied to ED care to improve communication for people living with dementia (PLWD). These strategies involve engaging every vital participant in clinical care: the patient, care partners, and the clinicians.

The Communications and Decision-Making Work Group identified two Patient Intervention Comparison Outcomes (PICO) questions to guide their literature review of publications related to communications and decision-making in the ED and other clinical settings.

  • PICO-1: How does communication and decision-making differ for PLWD compared to persons without dementia?
  • PICO-2: Are there specific medical communication strategies (e.g., Teach-back or nextday phone follow-up) that improve the process or outcomes of ED care in PLWD?

Top Research Priority Areas

The top voted communication and decision-making research priority areas ranked during the 2021 GEAR 2.0 Consensus Conference based on the scoping reviews are as follows: