Do You Feel The Churn?

by Dr. Linda Liotti, D.O.Do you feel the Churn?  Over the last thirty years, there have been changes in the hospice and palliative care industry. Years ago, nurses carried a case load of 12 – 15 patients. Each patient was seen on a regular basis, their needs and concerns taken care of by the nurse and multidisciplinary team on a weekly basis. Most patients would be followed until death, however a few graduated from hospice when the IDT found they had stabilized.Recently speaking with several colleagues, we noted a trend which suggests the turnaround time from admission to death continues to shrink. When we attend the interdisciplinary team meeting to discuss admissions, there are times where greater than 50% of patients admitted in the past two weeks, have already died. This trend suggests a phenomenon where admission to pronouncement has escalated with several consequences.First, is that nurses are spending 3+ hours to admit a patient and complete the electronic medical record (EMR) documentation. Before the social worker or chaplain have time to build a relationship, the nurse is already doing the pronouncement. This very rapid cycle leads to compassion fatigue and burnout for nurses, doctors and the rest of the team as the workload has become much heavier.Compassion FatigueCompassion fatigue has been described as persistent stress and anxiety with feelings of being overwhelmed and hopelessness. Due to the increased time necessary to complete an electronic record, cl...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: churn compassion fatigue length of stay Source Type: blogs