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https://www.readbyqxmd.com/read/27913246/measuring-content-overlap-during-handoff-communication-using-distributional-semantics-an-exploratory-study
#1
Joanna Abraham, Thomas Kannampallil, Vignesh Srinivasan, William Galanter, Gail Tagney, Trevor Cohen
OBJECTIVE: We develop and evaluate a methodological approach to measure the degree and nature of overlap in handoff communication content within and across clinical professions. This extensible, exploratory approach relies on combining techniques from conversational analysis and distributional semantics. MATERIALS AND METHODS: We audio-recorded handoff communication of residents and nurses on the General Medicine floor of a large academic hospital (n=120 resident and n=120 nurse handoffs)...
November 29, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27908501/prospective-evaluation-of-surgical-palliative-care-immersion-training-for-general-surgery-residents
#2
Mustafa Raoof, Lisa O'Neill, Leigh Neumayer, Mindy Fain, Robert Krouse
BACKGROUND: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. STUDY DESIGN: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework...
November 27, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27893952/acceptability-and-impact-of-a-required-palliative-care-rotation-with-prerotation-and-postrotation-observed-simulated-clinical-experience-during-internal-medicine-residency-training-on-primary-palliative-communication-skills
#3
Maxwell T Vergo, Sharona Sachs, Meredith A MacMartin, Kathryn B Kirkland, Amelia M Cullinan, Lisa A Stephens
BACKGROUND: Improving communication training for primary palliative care using a required palliative care rotation for internal medicine (IM) residents has not been assessed. OBJECTIVE: To assess skills acquisition and acceptability for IM residents not selecting an elective. DESIGN: A consecutive, single-arm cohort underwent preobjective structured clinical examination (OSCE) with learner-centric feedback, two weeks of clinical experience, and finally a post-OSCE to crystallize learner-centric take home points...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27850209/569-documentation-of-code-status-discussions-in-the-medical-intensive-care-unit
#4
Abigail Doyle, Elaine Chen
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27815753/pediatric-ethics-and-communication-excellence-peace-rounds-decreasing-moral-distress-and-patient-length-of-stay-in-the-picu
#5
Lucia Wocial, Veda Ackerman, Brian Leland, Brian Benneyworth, Vinit Patel, Yan Tong, Mara Nitu
This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers' moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation...
November 4, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/27720791/impact-of-palliative-care-screening-and-consultation-in-the-icu-a-multi-hospital-quality-improvement-project
#6
Robert J Zalenski, Spencer S Jones, Cheryl Courage, Denise R Waselewsky, Anna S Kostaroff, David Kaufman, Afzal Beemath, John Bronfman, James W Castillo, Hicham Krayem, Anthony Marinelli, Bradley Milner, Maria Teresa Palleschi, Mona Tareen, Sheri Testani, Ayman Soubani, Julie Walch, Judy Wheeler, Sonali Wilborn, Hanna Granovsky, Robert D Welch
CONTEXT: There are few multi-center studies that examine the impact of systematic screening for palliative care and specialty consultation in the ICU. OBJECTIVE: To determine the outcomes of receiving palliative care consultation (PCC) for patients who screened positive on palliative care referral criteria. METHODS: In a prospective quality assurance intervention with a retrospective analysis, the covariate balancing propensity score method was utilized to estimate the conditional probability of receiving a PCC and to balance important covariates...
October 5, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27644048/trend-of-decreased-length-of-stay-in-the-intensive-care-unit-icu-and-in-the-hospital-with-palliative-care-integration-into-the-icu
#7
Eluned Mun, Clementina Ceria-Ulep, Lillian Umbarger, Craig Nakatsuka
CONTEXT: Is a decrease in length of stay (LOS) in the intensive care unit (ICU) and hospital possible with the implementation of a structured, palliative care, quality-improvement program in the ICU? OBJECTIVE: Incorporate palliative care into the routine ICU workflow to increase the numbers of palliative care consultations, improve end-of-life care in the ICU, and demonstrate an impact on ICU and/or hospital LOS. DESIGN: A program was developed that followed recommendations from the Center to Advance Palliative Care's Improving Palliative Care in the ICU project...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27632677/a-comparison-of-usage-and-outcomes-between-nurse-practitioner-and-resident-staffed-medical-icus
#8
Rachel Scherzer, Marie P Dennis, Beth Ann Swan, Mani S Kavuru, David A Oxman
OBJECTIVE: To compare usage patterns and outcomes of a nurse practitioner-staffed medical ICU and a resident-staffed physician medical ICU. DESIGN: Retrospective chart review of 1,157 medical ICU admissions from March 2012 to February 2013. SETTING: Large urban academic university hospital. SUBJECTS: One thousand one hundred fifty-seven consecutive medical ICU admissions including 221 nurse practitioner-staffed medical ICU admissions (19...
September 14, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27622294/availability-of-advance-care-planning-documentation-for-older-emergency-department-patients-a-cross-sectional-study
#9
Timothy F Platts-Mills, Natalie L Richmond, Eric M LeFebvre, Sowmya A Mangipudi, Allison G Hollowell, Debbie Travers, Kevin Biese, Laura C Hanson, Angelo E Volandes
INTRODUCTION: Increasing advance care planning (ACP) among older adults is a national priority. Documentation of ACP in the electronic health record (EHR) is particularly important during emergency care. OBJECTIVE: We sought to characterize completion and availability of ACP among a subset of older patients at an academic emergency department (ED) with an integrated EHR. METHODS: In this cross-sectional study, patients were eligible if aged ≥80 years or aged 65-79 with ≥1 indicator of high risk for short-term mortality...
September 13, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27622148/criteria-for-level-1-and-level-2-trauma-codes-are-pelvic-ring-injuries-undertriaged
#10
Brittany E Haws, Scott Wuertzer, Laura Raffield, Leon Lenchik, Anna N Miller
AIM: To determine the association of unstable pelvic ring injuries with trauma code status. METHODS: A retrospective review of all pelvic ring injuries at a single academic center from July 2010 to June 2013 was performed. The trauma registry was used to identify level 1 and level 2 trauma codes for each injury. The computed tomography scans in all patients were classified as stable or unstable using the Abbreviated Injury Scale. Pelvic injury classifications in level 1 and level 2 groups were compared...
August 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27500355/the-default-dilemma-code-status-regardless-of-medical-context
#11
Daniel G Kronenberg, Chelsea H Hagmann, Joseph D Ma, Carolyn Revta, Janet Armstrong, Eric J Roeland
No abstract text is available yet for this article.
August 8, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27488959/when-terminal-illness-is-worse-than-death-a-multicenter-study-of-health-care-providers-resuscitation-desires
#12
Luis O Chavez, Sharon Einav, Joseph Varon
PURPOSE: To investigate how a terminal illness may affect the health-care providers' resuscitation preferences. METHODS: We conducted a cross-sectional survey in 9 health-care institutions located in 4 geographical regions in North and Central America, investigating attitudes toward end-of-life practices in health-care providers. Statistical analysis included descriptive statistics and χ(2) test for the presence of associations (P < 0.05 being significant) and Cramer V for the strength of the association...
August 3, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27348842/commentary-clarifying-medical-decisionmaking-who-how-and-why
#13
Tyler S Gibb, Michael J Redinger
In its simplest interpretation, this is a case about goals of care and appropriate code status. At the outset, we must confess that we found this case to be extremely interesting-not for the novelty of the issues or its ethical complexity but because it is truly a case of the ordinary. Too often when teaching or discussing clinical ethics cases, we are distracted by the exotic and the unusual and ignore the mundane cases that every practicing clinical ethicist must be able to competently manage. 1,2,3.
July 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/27301059/an-agenda-for-improving-perioperative-code-status-discussion
#14
Thomas R Hickey, Zara Cooper, Richard D Urman, David L Hepner, Angela M Bader
Code status discussions (CSDs) clarify patient preferences for cardiopulmonary resuscitation in the event of cardiac or respiratory arrest. CSDs are a key component of perioperative care, particularly at the end of life, and must be both patient-centered and shared. Physicians at all levels of training are insufficiently trained in and inappropriately perform CSD; this may be particularly true of perioperative physicians. In this article, we describe the difficulty of achieving a patient-centered, shared perioperative CSD in the case of a medical professional with a do-not-resuscitate order...
June 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27226151/barriers-and-perceptions-regarding-code-status-discussion-with-families-of-critically-ill-patients-in-a-tertiary-care-hospital-of-a-developing-country-a-cross-sectional-study
#15
Ahsan A Syed, Aysha Almas, Quratulain Naeem, Umer F Malik, Tariq Muhammad
BACKGROUND: In Asian societies including Pakistan, a complex background of illiteracy, different familial dynamics, lack of patient's autonomy, religious beliefs, and financial constraints give new dimensions to code status discussion. Barriers faced by physicians during code status discussion in these societies are largely unknown. AIM: To determine the barriers and perceptions in discussion of code status by physicians. DESIGN: Questionnaire-based cross-sectional study...
May 25, 2016: Palliative Medicine
https://www.readbyqxmd.com/read/27203483/emergency-physicians-experience-with-advance-care-planning-documentation-in-the-electronic-medical-record-useful-needed-and-elusive
#16
Joshua R Lakin, Eric Isaacs, Erin Sullivan, Heather A Harris, Ryan D McMahan, Rebecca L Sudore
OBJECTIVE: For patients' preferences to be honored, emergency department (ED) physicians must be able to find and use advance care planning (ACP) information in the electronic medical record (EMR). ED physicians' experiences with ACP EMR documentation and their documentation needs are unknown. METHODS: We surveyed 70 ED physicians (81% response rate) from a tertiary and county ED. Our primary outcome was confidence finding and using ACP EMR documentation (percentage reporting very/extremely on a five-point Likert scale)...
June 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27076725/do-not-resuscitate-an-expanding-role-for-critical-care-response-team
#17
Alaa M Gouda, Saad M Alqahtani
BACKGROUND: Do not resuscitate (DNR) order is an important aspect of medical practice. Since the implementation of critical care response team (CCRT), frequently we have encountered with patients in the wards that should have been made DNR. Initiating DNR became an important part of CCRT activity. We were obliged to extended the role of CCRT - beyond managing seriously ill patients - in addressing the code status for patients after discussion with the managing teams. PURPOSE: We compare the trend of initiation of DNR orders in the regular ward before and after implementing CCRT...
March 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27059989/communication-tools-for-end-of-life-decision-making-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#18
Simon J W Oczkowski, Han-Oh Chung, Louise Hanvey, Lawrence Mbuagbaw, John J You
BACKGROUND: For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27034434/caring-about-residents-experiences-and-symptoms-cares-program-a-model-of-palliative-care-consultation-in-the-nursing-home
#19
Deborah A Morris, Marissa Galicia-Castillo
OBJECTIVES: To describe the CARES program, a model of palliative care for nursing home residents. DESIGN: Descriptive analysis of the Caring About Residents' Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents. PROGRAM EVALUATION: The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred...
March 31, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/26991732/reengineering-dialysis-the-role-of-palliative-medicine
#20
Molly A Feely, Keith M Swetz, Kathryn Zavaleta, Björg Thorsteinsdottir, Robert C Albright, Amy W Williams
BACKGROUND: End-stage renal disease is a life-limiting illness associated with significant morbidity. Half of all individuals with end-stage renal disease are unable to participate in decision making at the end of life, which makes advance care planning critical in this population. OBJECTIVE: We sought to determine the feasibility of embedding palliative medicine consultations in the hemodialysis unit during treatment runs and the impact of this intervention on advance care planning and symptom management...
June 2016: Journal of Palliative Medicine
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