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Advanced care planning recording

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https://www.readbyqxmd.com/read/28926294/predictors-of-death-in-the-hospital-for-patients-with-chronic-serious-illness
#1
Katy Hicks, Lois Downey, Ruth A Engelberg, James A Fausto, Helene Starks, Ben Dunlap, James Sibley, William Lober, Nita Khandelwal, Elizabeth T Loggers, J Randall Curtis
BACKGROUND: Most people prefer to die at home, yet most do not. Understanding factors associated with terminal hospitalization may inform interventions to improve care. OBJECTIVE: Among patients with chronic illness receiving care in a multihospital healthcare system, we identified the following: (1) predictors of death in any hospital; (2) predictors of death in a hospital outside the system; and (3) trends from 2010 to 2015. DESIGN: Retrospective cohort using death certificates and electronic health records...
September 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#2
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28884703/definition-and-recommendations-for-advance-care-planning-an-international-consensus-supported-by-the-european-association-for-palliative-care
#3
REVIEW
Judith A C Rietjens, Rebecca L Sudore, Michael Connolly, Johannes J van Delden, Margaret A Drickamer, Mirjam Droger, Agnes van der Heide, Daren K Heyland, Dirk Houttekier, Daisy J A Janssen, Luciano Orsi, Sheila Payne, Jane Seymour, Ralf J Jox, Ida J Korfage
Advance care planning (ACP) is increasingly implemented in oncology and beyond, but a definition of ACP and recommendations concerning its use are lacking. We used a formal Delphi consensus process to help develop a definition of ACP and provide recommendations for its application. Of the 109 experts (82 from Europe, 16 from North America, and 11 from Australia) who rated the ACP definitions and its 41 recommendations, agreement for each definition or recommendation was between 68-100%. ACP was defined as the ability to enable individuals to define goals and preferences for future medical treatment and care, to discuss these goals and preferences with family and health-care providers, and to record and review these preferences if appropriate...
September 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28882812/health-information-technology-hit-adaptation-refocusing-on-the-journey-to-successful-hit-implementation
#4
Po-Yin Yen, Ann Scheck McAlearney, Cynthia J Sieck, Jennifer L Hefner, Timothy R Huerta
In past years, policies and regulations required hospitals to implement advanced capabilities of certified electronic health records (EHRs) in order to receive financial incentives. This has led to accelerated implementation of health information technologies (HIT) in health care settings. However, measures commonly used to evaluate the success of HIT implementation, such as HIT adoption, technology acceptance, and clinical quality, fail to account for complex sociotechnical variability across contexts and the different trajectories within organizations because of different implementation plans and timelines...
September 7, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28870384/top-ten-challenges-when-interfacing-a-laboratory-information-system-to-an-electronic-health-record-experience-at-a-large-academic-medical-center
#5
Athena K Petrides, Milenko J Tanasijevic, Ellen M Goonan, Adam B Landman, Michalis Kantartjis, David W Bates, Stacy E F Melanson
BACKGROUND: Recent U.S. government regulations incentivize implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR to their laboratory information system (LIS). Reported long-term benefits include increased efficiency and improved quality and safety. In order to successfully implement an interfaced EHR-LIS, institutions must plan years in advance and anticipate the impact of an integrated system...
October 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28865870/outcomes-that-define-successful-advance-care-planning-a-delphi-panel-consensus
#6
Rebecca L Sudore, Daren K Heyland, Hillary D Lum, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Karl Lorenz, Michelle Howard, Michael J Green, Jessica E Simon, Mariko A Feuz, John J You
CONTEXT: Standardized outcomes that define successful advance care planning (ACP) are lacking. OBJECTIVE: To create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. METHODS: This study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from 5 international ACP conferences to identify initial ACP outcome constructs...
August 30, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28864448/discussion-and-documentation-of-future-care-a-before-and-after-study-examining-the-impact-of-an-alternative-approach-to-recording-treatment-decisions-on-advance-care-planning-in-an-acute-hospital
#7
Alexandra C Malyon, Julia R Forman, Jonathan P Fuld, Zoë Fritz
OBJECTIVE: To determine whether discussion and documentation of decisions about future care was improved following the introduction of a new approach to recording treatment decisions: the Universal Form of Treatment Options (UFTO). METHODS: Retrospective review of the medical records of patients who died within 90 days of admission to oncology or respiratory medicine wards over two 3-month periods, preimplementation and postimplementation of the UFTO. A sample size of 70 per group was required to provide 80% power to observe a change from 15% to 35% in discussion or documentation of advance care planning (ACP), using a two-sided test at the 5% significance level...
September 1, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28863160/high-rates-of-loss-to-follow-up-during-the-first-year-of-pre-antiretroviral-therapy-for-hiv-patients-at-sites-providing-pre-art-care-in-nigeria-2004-2012
#8
Simon G Agolory, Andrew F Auld, Solomon Odafe, Ray W Shiraishi, E Kainne Dokubo, Mahesh Swaminathan, Ibrahim Dalhatu, Dennis Onotu, Oseni Abiri, Henry Debem, Adebobola Bashorun, Tedd V Ellerbrock
BACKGROUND: With about 3.4 million HIV-infected persons, Nigeria has the second highest number of people living with HIV (PLHIV) in the world. However, antiretroviral treatment (ART) coverage in Nigeria remains low with only 748,846 (22%) of PLHIV on ART by the end of 2014. Retention of HIV-infected patients in pre-ART care is essential to ensure timely ART initiation. We assessed outcomes of patients enrolled in Nigeria's pre-ART program during 2004-2012. METHODS: We conducted a nationally representative retrospective cohort study among adults (≥15 years old), enrolling in pre-ART programs supported by the U...
2017: PloS One
https://www.readbyqxmd.com/read/28852789/a-multi-center-prospective-cohort-study-of-patient-transfers-from-the-intensive-care-unit-to-the-hospital-ward
#9
Henry T Stelfox, Jeanna Parsons Leigh, Peter M Dodek, Alexis F Turgeon, Alan J Forster, Francois Lamontagne, Rob A Fowler, Andrea Soo, Sean M Bagshaw
PURPOSE: To provide a 360-degree description of ICU-to-ward transfers. METHODS: Prospective cohort study of 451 adults transferred from a medical-surgical ICU to a hospital ward in 10 Canadian hospitals July 2014-January 2016. Transfer processes documented in the medical record. Patient (or delegate) and provider (ICU/ward physician/nurse) perspectives solicited by survey 24-72 h after transfer. RESULTS: Medical records (100%) and survey responses (ICU physicians-80%, ICU nurses-80%, ward physicians-46%, ward nurses-64%, patients-74%) were available for most transfers...
August 29, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28797865/increasing-advance-care-planning-completion-at-an-academic-internal-medicine-outpatient-clinic
#10
Ngoc-Phuong Luu, Candace Nigrin, Kimberly Peairs, Sydney M Dy, Melinda Sawyer, Samantha Pitts, Brent Petty
BACKGROUND: We sought to increase advance care planning completion at an academic internal medicine clinic through an electronic health record. MEASURES: Number of eligible patients who completed a form of advance care planning. INTERVENTION: Multidisciplinary team approach with engagement from providers and clinic staff; implemented informational letter and appropriate forms to eligible patients prior to appointment; informational video and provider reminders at time of appointment...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28775218/predictive-factors-for-length-of-hospital-stay-following-primary-total-knee-replacement-in-a-total-joint-replacement-centre-in-hong-kong
#11
C K Lo, Q J Lee, Y C Wong
INTRODUCTION: The demand for total knee replacement in Hong Kong places tremendous economic burden on our health care system. Shortening hospital stay reduces the associated cost. The aim of this study was to identify perioperative predictors of length of hospital stay following primary total knee replacement performed at a high-volume centre in Hong Kong. METHODS: We retrospectively reviewed all primary total knee replacements performed at Yan Chai Hospital Total Joint Replacement Centre from October 2011 to October 2015...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28767296/advance-care-planning-discussions-with-adolescent-and-young-adult-cancer-patients-admitted-to-a-community-palliative-care-service-a-retrospective-case-note-audit
#12
Sophie Fletcher, Rachel Hughes, Sarah Pickstock, Kirsten Auret
PURPOSE: Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. METHODS: Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015...
August 2, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28760834/validation-of-quality-indicators-for-end-of-life-communication-results-of-a-multicentre-survey
#13
MULTICENTER STUDY
Daren K Heyland, Peter Dodek, John J You, Tasnim Sinuff, Tim Hiebert, Carolyn Tayler, Xuran Jiang, Jessica Simon, James Downar
BACKGROUND: The lack of validated quality indicators is a major barrier to improving end-of-life communication and decision-making. We sought to show the feasibility of and provide initial validation for a set of quality indicators related to end-of-life communication and decision-making. METHODS: We administered a questionnaire to patients and their family members in 12 hospitals and asked them about advance care planning and goals-of-care discussions. Responses were used to calculate a quality indicator score...
July 31, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28750905/automated-problem-list-generation-and-physicians-perspective-from-a-pilot-study
#14
Murthy V Devarakonda, Neil Mehta, Ching-Huei Tsou, Jennifer J Liang, Amy S Nowacki, John Eric Jelovsek
OBJECTIVE: An accurate, comprehensive and up-to-date problem list can help clinicians provide patient-centered care. Unfortunately, problem lists created and maintained in electronic health records by providers tend to be inaccurate, duplicative and out of date. With advances in machine learning and natural language processing, it is possible to automatically generate a problem list from the data in the EHR and keep it current. In this paper, we describe an automated problem list generation method and report on insights from a pilot study of physicians' assessment of the generated problem lists compared to existing providers-curated problem lists in an institution's EHR system...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28739159/lung-stereotactic-body-radiation-therapy-sbrt-for-early-stage-non-small-cell-lung-cancer-in-the-very-elderly-%C3%A2-80years-old-extremely-safe-and-effective
#15
Paul Kreinbrink, Philip Blumenfeld, George Tolekidis, Neilayan Sen, David Sher, Gaurav Marwaha
OBJECTIVE: Stereotactic body radiotherapy (SBRT) for early-stage non-small-cell lung cancer (NSCLC) is the standard of care in medically inoperable patients. In very elderly patients, previous studies have shown SBRT to offer excellent local control, though with higher toxicities than in younger populations. We report our institutional experience using SBRT in the definitive management of NSCLC in patients ≥80years old. MATERIALS AND METHODS: Using an IRB-approved registry of 158 patients treated with definitive-intent lung SBRT for early-stage NSCLC at our institution between 2010 and 2016, 31 consecutively treated patients ≥80years of age were identified...
July 21, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28720558/my-team-of-care-study-a-pilot-randomized-controlled-trial-of-a-web-based-communication-tool-for-collaborative-care-in-patients-with-advanced-cancer
#16
Teja Voruganti, Eva Grunfeld, Trevor Jamieson, Allison M Kurahashi, Bhadra Lokuge, Monika K Krzyzanowska, Muhammad Mamdani, Rahim Moineddin, Amna Husain
BACKGROUND: The management of patients with complex care needs requires the expertise of health care providers from multiple settings and specialties. As such, there is a need for cross-setting, cross-disciplinary solutions that address deficits in communication and continuity of care. We have developed a Web-based tool for clinical collaboration, called Loop, which assembles the patient and care team in a virtual space for the purpose of facilitating communication around care management...
July 18, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28697791/blood-transfusion-in-elderly-patients-with-chronic-anemia-a-qualitative-analysis-of-the-general-practitioners-attitudes
#17
Sylvain Le Calvé, Dominique Somme, Joaquim Prud'homm, Aline Corvol
BACKGROUND: Blood transfusion in chronic anemia is not covered by guidelines specific to older adults. When they consider that this treatment is necessary in elderly patients, French general practitioners (GPs) contact a hospital specialist to plan a transfusion. METHODS: Twenty French GPs were questioned individually regarding their approach to blood transfusion using semi-structured interviews. Each interview was recorded, typed up verbatim and then coded using an inductive procedure by theme, in a cross-over design (two researchers) in two phases: analysis and summary, followed by grouping of the recorded comments...
July 11, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28694253/implementing-the-compassion-intervention-a-model-for-integrated-care-for-people-with-advanced-dementia-towards-the-end-of-life-in-nursing-homes-a-naturalistic-feasibility-study
#18
Kirsten J Moore, Bridget Candy, Sarah Davis, Anna Gola, Jane Harrington, Nuriye Kupeli, Victoria Vickerstaff, Michael King, Gerard Leavey, Irwin Nazareth, Rumana Z Omar, Louise Jones, Elizabeth L Sampson
BACKGROUND: Many people with dementia die in nursing homes, but quality of care may be suboptimal. We developed the theory-driven 'Compassion Intervention' to enhance end-of-life care in advanced dementia. OBJECTIVES: To (1) understand how the Intervention operated in nursing homes in different health economies; (2) collect preliminary outcome data and costs of an interdisciplinary care leader (ICL) to facilitate the Intervention; (3) check the Intervention caused no harm...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28691498/delivering-end-of-life-cancer-care-perspectives-of-providers
#19
Manali I Patel, Vyjeyanthi S Periyakoil, David Moore, Andrea Nevedal, Tumaini R Coker
OBJECTIVES: Persistent gaps in end-of-life cancer care delivery and growing associated expenditures remain imminent US public health issues. The objective of this study was to understand clinical providers' experiences delivering cancer care for patients at the end of life and their perspectives on potential solutions to improve quality of care. METHODS: Semistructured interviews were conducted with 75 cancer care providers across the United States. The interviews were recorded, transcribed, and analyzed using constant comparative method of qualitative analysis...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28665744/if-we-don-t-ask-our-patients-might-never-tell-the-impact-of-the-routine-use-of-a-patient-values-assessment
#20
J Russell Hoverman, Cynthia Taniguchi, Kathryn Eagye, Sabrina Mikan, Angela Kalisiak, Susan Ash-Lee, Rhonda Henschel
PURPOSE: Good communication can be associated with better end-of-life outcomes. The US Oncology Network developed and tested a Values Assessment (VA) for facilitating advance care planning (ACP). The results of the first 1,268 patients are reported. METHODS: The VA consists of 10 questions of the format "How valuable is it to me to…" (eg, "...know that I am not a burden to my family, friends, or helpers?"). Responses were on a four-point scale from unsure to very valuable...
June 30, 2017: Journal of Oncology Practice
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