Please select the eligibility criteria that correspond to the clinical trial below.
Title: Serious Illness Communication Project
Brief Summary: The purpose of the study is to evaluate the impact of implementing a "Serious Illness Conversation Guide" to guide patient/family-clinician discussions and planning about end-of-life care decisions. The goal of the intervention is to improve achievement of patient care priorities and peacefulness at the end of life for patients with serious and life-threatening illness and their families. We hypothesize that patients whose physician is trained to use and adheres to the elements of the Serious Illness Conversation Guide will demonstrate enhanced consistency between documented key priorities and care received, and will experience greater peace in the final month of life; similarly, their families will experience higher satisfaction with care.


Options:
A: DISEASE CHARACTERISTICS:

* Overdue for colorectal cancer screening (identified using automated extracts from the electronic medical record), as defined by the following criteria:

  * No fecal occult blood test within the past 12 months
  * No flexible sigmoidoscopy within the past 5 years
  * No colonoscopy within the past 10 years
* Receiving primary care at a Harvard Vanguard Medical Associates (HVMA) center
* Registered to use the HVMA patient portal (MyHealth) AND has an active MyHealth account

PATIENT CHARACTERISTICS:

* Not specified

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
B: The subjects of this study will be the clinicians (physicians and nurse practitioners) conducting the SICG conversations, their patient with high-risk cancers, and a friend or family member of the patient.

Clinician Inclusion Criteria:

1. Dana-Farber Cancer Institute medical oncology clinician
2. Care for patients with selected high-risk cancers

Clinician Exclusion Criteria:

1. DFCI Gynecology-Oncology specialist
2. Seeing patients only in the Phase I clinical trial disease center

Patient Inclusion Criteria

1. Over 18 years of age
2. English speaker
3. Patient at Dana-Farber Cancer Institute, including satellite sites at Milford Regional Medical Center and South Shore Hospital
4. Diagnosis of one of the following high mortality or advanced cancers: breast, gastric, intestinal, esophageal, pancreatic, biliary, colorectal, hepatocellular, head and neck, renal, bladder, prostate, acute myeloid lymphoma (AML), acute lymphoblastic lymphoma (ALL), lymphoma, melanoma, glioblastoma multiforme (GBM), sarcoma, and lung.
5. Ability to provide consent

Patient Exclusion Criteria

1. Diagnosis of advanced obstetric-gynecological cancer
2. Cognitive impairment

Family Member Inclusion Criteria

1. Over 18 years of age
2. English speaker
3. Friend or family member of study patient (Health care proxy, or close friend or family member who is involved in helping the patient think about decisions related to their health care)
4. Ability to provide consent
C: DISEASE CHARACTERISTICS:

* Primary care providers and their patients in the Brigham and Women's Primary Care Practice-Based Research Network
* Patient is currently a smoker

PATIENT CHARACTERISTICS:

* Must speak English or Spanish
* No significant cognitive impairment (e.g., dementia or active psychosis)

PRIOR CONCURRENT THERAPY:

* Not specified
D: Inclusion Criteria:

* Acutely ill medical patients admitted to medical wards

Exclusion Criteria:

* Indication for therapeutic anticoagulation or ongoing therapeutic anticoagulant treatment

Answer: B