The Impact of Palliative Medicine on Franciscan St. Francis Health

2012 ◽  
Vol 14 (3) ◽  
pp. 210-215
Author(s):  
Cecilia Quade ◽  
Martha J. Yoder
2011 ◽  
Vol 9 (4) ◽  
pp. 401-406 ◽  
Author(s):  
Dana Lustbader ◽  
Renee Pekmezaris ◽  
Michael Frankenthaler ◽  
Rajni Walia ◽  
Frederick Smith ◽  
...  

AbstractObjective:The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.Method:A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study.Results:Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test,p < 0.01). Time from MICU admission until death was also reduced (log-rank test,p < 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2test,p < 0.0001).Significance of results:Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group.


1999 ◽  
Vol 13 (4) ◽  
pp. 273-274 ◽  
Author(s):  
Irene J Higginson ◽  
Alan M McGregor

Author(s):  
Ambereen K. Mehta ◽  
Rishi Patel ◽  
Dheer Patel ◽  
Mellar P. Davis

Background: There has been a call for palliative care (PC) published research to support the impact and need for more specialty PC services. Objective: The purpose of this study was to characterize research in PC over a 15-year period in 3 PC journals published in the United States. Design: The authors reviewed every issue of the Journal of Pain and Symptom Management, Journal of Palliative Medicine, and American Journal of Hospice and Palliative Medicine from 2004 through 2018. Studies included were original articles and brief reports. Study type (qualitative, quantitative), author (first and last), gender, and professional degree of the author (first and last) were recorded. Results: A total of 4881 articles were included in this study. The proportion of quantitative papers significantly increased across 3 time points from 63% to 67% to 78%. The proportion of women first authors increased across all 3 time points (54%, 2004-2008; 57%, 2009-2013; 60%, 2014-2018), and the proportion of women last authors increased across all time points (38%, 2004-2008; 44%, 2009-2013; 46%, 2014-2018). More than 40% of authors were physicians. Conclusions: Published PC studies are increasingly quantitative in design. Gender authorship is female dominant for the first authors and increasingly equal across genders for the last authors.


2002 ◽  
Vol 10 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Jade Homsi ◽  
Declan Walsh ◽  
Kristine A. Nelson ◽  
Susan B. LeGrand ◽  
Mellar Davis ◽  
...  

2019 ◽  
Vol 24 (3) ◽  
pp. 155-163
Author(s):  
Eoin Tiernan ◽  
John Ryan ◽  
Mary Casey ◽  
Aine Hale ◽  
Valerie O’Reilly ◽  
...  

Objective To evaluate a new intervention intended to increase referral rates from the emergency department (ED) to the palliative medicine service (PMS) in acute hospitals. Methods We conducted a quasi-experimental evaluation in an urban teaching hospital in Dublin, Ireland. Data were collected over two eight-week periods in November/December 2013 and May/June 2015, with the PALliative Medicine in the Emergency Department (PAL.M.ED.™) intervention implemented in the intervening period. All adults who were admitted to the hospital via the ED during the two time periods and who received a palliative care consultation during their hospital stay were included in the study. Our primary analysis evaluated the impact of PAL.M.ED.™ on PMS referral in the ED. Our secondary analysis evaluated the impact of PMS referral in the ED on length of stay (LOS) and utilization, compared to PMS referral later in the admission. We controlled for observed confounding between groups using propensity scores. Results PAL.M.ED.™ was associated with an increase in PMS referral in the ED ( p < 0.005; odds ratio: 10.5 (95%CI: 3.8 to 28.7)). PMS referral in the ED was associated with shorter hospital LOS ( p < 0.005; −10.9 days (95%CI: −17.7 to −4.1)). Conclusions Low PMS referral rates in the ED, and the poor outcomes for patients and hospitals that arise from admissions of those with serious illness, may be mitigated by a proactive intervention to identify appropriate patients at admission.


2016 ◽  
Vol 34 (7) ◽  
pp. 603-610 ◽  
Author(s):  
Arun L. Singh ◽  
Jeffrey C. Klick ◽  
Courtney E. McCracken ◽  
Kiran B. Hebbar

Background: Hospice and Palliative Medicine (HPM) competencies are of growing importance in training general pediatricians and pediatric sub-specialists. The Accreditation Council for Graduate Medical Education (ACGME) emphasized pediatric trainees should understand the “impact of chronic disease, terminal conditions and death on patients and their families.” Currently, very little is known regarding pediatric trainee education in HPM. Methods: We surveyed all 486 ACGME-accredited pediatric training program directors (PDs) - 200 in general pediatrics (GP), 57 in cardiology (CARD), 64 in critical care medicine (CCM), 69 in hematology-oncology (ONC) and 96 in neonatology (NICU). We collected training program’s demographics, PD’s attitudes and educational practices regarding HPM. Results: The complete response rate was 30% (148/486). Overall, 45% offer formal HPM curriculum and 39% offer a rotation in HPM for trainees. HPM teaching modalities commonly reported included conferences, consultations and bedside teaching. Eighty-one percent of all respondents felt that HPM curriculum would improve trainees’ ability to care for patients. While most groups felt that a HPM rotation would enhance trainees’ education [GP (96%), CARD (77%), CCM (82%) and ONC (95%)], NICU PDs were more divided (55%; p < 0.05 for all comparisons vs. NICU). Conclusion: While most programs report perceived benefit from HPM training, there remains a paucity of opportunities for pediatric trainees. Passive teaching methods are frequently utilized in HPM curricula with minimal diversity in methods utilized to teach HPM. Opportunities to further emphasize HPM in general pediatric and pediatric sub-specialty training remains.


2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 137-137
Author(s):  
Gene Decastro ◽  
Bridget Earle

137 Background: As patients with hematologic malignancies further enter the scope of practice for palliative medicine physicians, it is important to have an accurate view of their needs. Historically, there is a paucity of research examining symptom burden in this cohort. Even fewer studies explore the experience and perceptions of frontline hematology providers. As our Geriatrics and Palliative Medicine team at North Shore University Hospital (NSUH) embarked upon a collaborative Supportive Care model on our hospital’s dedicated Leukemia and Bone Marrow units, it was important to gain insight from providers about this population. Methods: We conducted a supportive care needs assessment survey of the staff (faculty, fellows, nurse practitioners, nurses, social workers, and case management) from the Leukemia and Bone Marrow units. The survey encompassed eighteen domains and attempted to assess their prevalence in patients according to the Hematology team. It included symptom burden, social and functional complexities, advance care planning, and goals of care. Free text responses were used to capture staff input about challenges in caring for this population Results: We received a response rate of 30% (30/101) with respondents primarily being nurses. It revealed the domains most commonly seen in this patient population by the team. Domains selected as “frequently” or “almost always” were fatigue (97%), nutritional issues (96%), gastrointestinal issues (93%), anxiety (80%), goals of care (69%), and advance directives (69%). We learned that symptom management was a challenge for the staff. They expressed that patients’ expectations about the impact of chemotherapy is a key area of importance. Lastly, communication with patients throughout treatment and caregiver support were consistent concerns from the team. Conclusions: Determining the four most prominent issues encountered by hematology staff were fatigue, nutritional, gastrointestinal, and anxiety can help to refine the symptom assessment. Moreover, communication and decision making concerns were important. These results underscore the necessity of assessing provider perspectives while treating those with hematologic malignancies to guide future initiatives.


Author(s):  
Erica Schockett ◽  
Mary Ishola ◽  
Taylor Wahrenbrock ◽  
Annabelle Croskey ◽  
Shannon Cain ◽  
...  

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