Caroline M. Quill, M.D.

As a health services researcher, I am interested in improving the care of seriously ill patients, both in the ICU and outpatient settings. By combining "big data" analysis with survey data and qualitative "patient-level" research, I aim to use the wealth of data we have available through the electronic medical record to better understand patient experience. With my research team at the Rochester Center for Health Informatics, I am developing novel analytic techniques such as network analysis to evaluate the ways that patients move throughout the hospital and the implications for ICU readmissions, disease transmission, and end-of-life care.

I am also interested in provider-patient communication regarding difficult decisions at the end of life. Because of competing time interests, discussions regarding advance directives and "code status" are often rushed and lack tailored information regarding individual patient prognosis from an experienced provider. My prior work has looked at variations in DNR/DNI order writing among intensive care units in the United States. I am currently conducting survey and qualitative research regarding end-of-life discussions and advance directives among seriously ill outpatients. My hypothesis is that many patients have a limited understanding of the options available as well as the implications of the option they select. Ultimately, I plan to develop interventions to improve patient and surrogate understanding of the various treatment options near the end of life, including the use of default options in advance directives for seriously ill patients.