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https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#1
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28820620/care-providers-integration-of-family-requests-in-end-of-life-communication-understanding-what-to-do-and-why-to-do-it
#2
Paula Hopeck
End-of-life situations are fraught with challenges for patients, family members, and individuals working at the patient's bedside. Care workers must address needs of the patient, as well as his or her distressed family members. This article is an inductive investigation of care workers' (nurses, patient advocates, and clergy) experiences with end-of-life discussions when the family asks to "do everything." Participants also noted resistance to hospice in some of these encounters based on pre-existing connotations of hospice held by the family members...
August 18, 2017: Health Communication
https://www.readbyqxmd.com/read/28818629/hospice-she-yelped-examining-the-quantity-and-quality-of-decision-support-available-to-patient-and-families-considering-hospice
#3
Grace Finnigan-Fox, Dan D Matlock, Channing E Tate, Christopher E Knoepke, Larry A Allen
BACKGROUND: Whether to engage hospice is one of the most difficult medical decisions patients and families make. Meanwhile, misperceptions about hospice persist. Within this context, the breadth and depth of patient decision support materials for hospice is unknown. OBJECTIVE: Identify available patient decision aids (PtDAs) relating information about hospice care and compare that information to the informational needs expressed by real-world healthcare consumers...
August 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#4
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817366/trajectory-of-dyspnea-and-respiratory-distress-among-patients-in-the-last-month-of-life
#5
Margaret L Campbell, Jason M Kiernan, John Strandmark, Hossein N Yarandi
BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817348/palliative-care-consults-in-u-s-nursing-homes-not-just-for-the-dying
#6
Julie C Lima, Susan C Miller
BACKGROUND: Little is known about nursing home (NH) residents who receive palliative care (PC) consults in the United States. OBJECTIVE: Separately by short versus long (≥90 days) stays, to describe NH residents with PC consults compared to a prevalent NH sample. DESIGN: Descriptive longitudinal study. SETTING/SUBJECTS: NH residents in 2008-2010 in 54 NHs. MEASUREMENTS: Resident characteristics came from merged Medicare and NH data from the Centers for Medicare and Medicaid Services and consult information from two PC organizations that were the sole PC consult providers in the study NHs...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28814321/relatives-perceived-quality-of-palliative-care-comparisons-between-care-settings-in-which-patients-die
#7
Dolf de Boer, Jolien M Hofstede, Anke J E de Veer, Natasja J H Raijmakers, Anneke L Francke
BACKGROUND: Dying in the preferred setting is an indicator of good palliative care quality. Most people prefer to die at home. But does the quality of care as perceived by their relatives vary depending on the care setting that is the place of death? The aim is to compare (from the relatives perspective) whether there are perceived differences in the quality of palliative care between the settings in which people die. METHODS: Multivariate linear regression analyses have been carried out using an existing dataset containing information collected using the relatives' version of the Consumer Quality Index (CQ-index) Palliative Care...
August 16, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28813635/standardization-and-scaling-of-a-community-based-palliative-care-model
#8
Janet Bull, Arif H Kamal, Matthew Harker, Donald H Taylor, Lindsay Bonsignore, John Morris, Lisa Massie, Parampal Singh Bhullar, Mary Howell, Mark Hendrix, Deeana Bennett, Amy Abernethy
BACKGROUND: Although limited, the descriptions of Community-Based Palliative Care (CBPC) demonstrates variability in team structures, eligibility, and standardization across care settings. OBJECTIVE: In 2014, Four Seasons Compassion for Life, a nonprofit hospice and palliative care (PC) organization in Western North Carolina (WNC), was awarded a Centers for Medicare and Medicaid Services Health Care Innovation (CMMI) Award to expand upon their existing innovative model to implement, evaluate, and demonstrate CBPC in the United States...
August 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28813191/effect-and-efficiency-of-an-embedded-palliative-care-nurse-practitioner-in-an-oncology-clinic
#9
Anne M Walling, Sarah F D'Ambruoso, Jennifer L Malin, Sara Hurvitz, Ann Zisser, Anne Coscarelli, Robin Clarke, Andrew Hackbarth, Christopher Pietras, Frances Watts, Bruce Ferrell, Samuel Skootsky, Neil S Wenger
PURPOSE: To test a simultaneous care model for palliative care for patients with advanced cancer by embedding a palliative care nurse practitioner (NP) in an oncology clinic. METHODS: We evaluated the effect of the intervention in two oncologists' clinics beginning March 2014 by using implementation strategies, including use of a structured referral mechanism, routine symptom screening, integration of a psychology-based cancer supportive care center, implementation team meetings, team training, and a metrics dashboard for continuous quality improvement...
August 16, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28812945/phase-of-illness-in-palliative-care-cross-sectional-analysis-of-clinical-data-from-community-hospital-and-hospice-patients
#10
Harriet Mather, Ping Guo, Alice Firth, Joanna M Davies, Nigel Sykes, Alison Landon, Fliss Em Murtagh
BACKGROUND: Phase of Illness describes stages of advanced illness according to care needs of the individual, family and suitability of care plan. There is limited evidence on its association with other measures of symptoms, and health-related needs, in palliative care. AIMS: The aims of the study are as follows. (1) Describe function, pain, other physical problems, psycho-spiritual problems and family and carer support needs by Phase of Illness. (2) Consider strength of associations between these measures and Phase of Illness...
August 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28810503/two-is-a-perfect-number-patient-doctor-relationship-and-patient-attachment-style-in-palliative-care
#11
Iwona Zaporowska-Stachowiak, Katarzyna Stachowiak, Katarzyna Stachnik
We tested the association between the palliative patient's attachment style and the patient-doctor relationship, by means of Revised Adult Attachment Scale and a self-designed, patient-doctor relationship questionnaire. The study included 110 (52 M, 58 F) cancer, hospice patients, aged 36-80 years. We observed 54 percent of secure, 18 percent of dismissive, 9 percent of preoccupied, and 19 percent of fearful styles. Securely attached patients developed significantly ( p < .05) better relationships with doctors than insecure patients...
August 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28807707/quality-improvement-pearls-for-the-palliative-care-and-hospice-professional
#12
Arif H Kamal, Jonathan M Nicolla, Steve Power
Rapid changes in how palliative care clinicians are evaluated and paid present an imperative for clinicians to adeptly and routinely perform quality improvement in usual practice. Like empathic communication and facilitating goals of care discussions, quality improvement skills must be learned, honed, and practiced so identifying problems and brainstorming solutions becomes a natural component of delivering serious illness care. Using our experience in both failures and successes in performing quality improvement, herein we provide a prioritized list of ten pearls specifically aimed to palliative care and hospice professionals...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28807702/factors-associated-with-use-of-u-s-community-based-palliative-care-for-children-with-life-limiting-or-life-threatening-illnesses-and-their-families-an-integrative-review
#13
REVIEW
Jackelyn Y Boyden, Martha A Q Curley, Janet A Deatrick, Mary Ersek
CONTEXT: As children with life-limiting and life-threatening illnesses live longer, challenges to meeting their complex health care needs arise in homes and communities, as well as in hospitals. Integrated knowledge regarding community-based pediatric palliative care (CBPPC) is needed to strategically plan for a seamless continuum of care for children and their families. OBJECTIVE: The purpose of this integrative review paper is to explore factors that are associated with the use of CBPPC for U...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28806810/correction-the-relationship-of-obesity-to-hospice-use-and-expenditures
#14
(no author information available yet)
No abstract text is available yet for this article.
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28805360/medicare-program-fy-2018-hospice-wage-index-and-payment-rate-update-and-hospice-quality-reporting-requirements-final-rule
#15
(no author information available yet)
This final rule will update the hospice wage index, payment rates, and cap amount for fiscal year (FY) 2018. Additionally, this rule includes new quality measures and provides an update on the hospice quality reporting program.
August 4, 2017: Federal Register
https://www.readbyqxmd.com/read/28804877/validation-of-a-geriatric-trauma-prognosis-calculator-a-p-a-l-li-a-t-e-consortium-study
#16
Allyson C Cook, Bellal Joseph, M Jane Mohler, Kenji Inaba, Brandon R Bruns, Paul A Nakonezny, Jeff D Kerby, Karen J Brasel, Steven E Wolf, Joseph Cuschieri, M Elizabeth Paulk, Ramona L Rhodes, Scott C Brakenridge, A Peter Ekeh, Herb A Phelan
BACKGROUND/OBJECTIVES: The P.A.L.Li.A.T.E. (prognostic assessment of life and limitations after trauma in the elderly) consortium has previously created a prognosis calculator for mortality after geriatric injury based on age, injury severity, and transfusion requirement called the geriatric trauma outcome score (GTOS). Here, we sought to create and validate a prognosis calculator called the geriatric trauma outcome score ii (GTOS II) estimating probability of unfavorable discharge. DESIGN: Retrospective cohort...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28803085/palliative-care-in-south-africa
#17
Cornelia Drenth, Zodwa Sithole, Esme Pudule, Sheryl Wüst, Nicola GunnClark, Liz Gwyther
The Hospice Palliative Care Association (HPCA) was established in 1987 by hospices in South Africa who felt the need for a national body to share best practices and to promote palliative care services in South Africa. HPCA supports member hospices in providing palliative care to people of any age with a life-limiting condition. HPCA has the further aim to ensure access to palliative care in settings other than member hospices. Many projects were launched over the years to influence policy, and to educate medical practitioners, nurses, social workers, theologians, and community caregiver; and to develop services...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803083/the-impact-of-combined-use-of-opioids-antipsychotics-and-anxiolytics-on-survival-in-the-hospice-setting
#18
Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Aleksandar Čubranić
CONTEXT: Opioids and sedatives are the cornerstone of symptom management in the end-of-life patients, but undertreatment is a common problem. Although several studies explored the individual effect of opioids, anxiolytics and antipsychotics on survival, not much is known regarding their combined use. As these drugs share similar and potentially fatal side effects, primarily respiratory depression which occurs more often during night-hours, it is crucial to explore whether their interaction poses a danger for fragile hospice patients...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803082/addressing-patient-emotional-and-existential-needs-during-serious-illness-results-of-the-outlook-randomized-controlled-trial
#19
Karen E Steinhauser, Stewart Alexander, Maren K Olsen, Karen M Stechuchak, Jennifer Zervakis, Natalie Ammarell, Ira Byock, James A Tulsky
CONTEXT: Few interventions exist to address patients' existential needs. OBJECTIVE: Determine whether an intervention to address seriously-ill patients' existential concerns improves preparation, completion (elements of quality-of-life at end-of-life) and reduces anxiety and depression. METHODS: A randomized control trial comparing: 1)Outlook intervention, 2)Relaxation meditation (RM); and 3)Usual care (UC). Measures included: primary - quality-of-life (QUAL-E) and secondary - FACT-G, anxiety (POMS), depression (CES-D), and spiritual well-being (FACIT-sp)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803074/hospice-palliative-care-development-in-hungary
#20
Agnes Csikos, Csilla Busa, Katalin Muszbek
During the past 25 years many developmental steps have occurred in Hungary in palliative care. Further education and service development is needed to provide a quality palliative care for all the Hungarian people. Hungary has a universal health care system with a developed infrastructure. The first Hungarian hospice team started in 1991. At that time the concept of hospice care was unknown. Symptom control and psychosocial support for the dying patient was inadequate. The regulatory framework was based on the 1997 Health Care Act which was followed by significant palliative care legislation including documents on the legal requirements for palliative care (2004)...
August 9, 2017: Journal of Pain and Symptom Management
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