Quiet: How to Harness the Strengths of Introverts to Transform How We Work, Lead, and Innovate (101)
Did you know that introverted leaders often deliver better results than extroverts? That the most spectacularly creative people tend to be introverts? That the most innovative thinking happens alone and not in teams? One of the central challenges of any business is to bring out the best in its employees. Yet when it comes to introverts —who make up a third to a half of the workforce—our leadership strategy mainly consists of asking them to act like extroverts. This is a serious waste of talent and energy. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Susan Cain Source Type: research

Palliative Care in Rural Settings: Closing the Gap (TH312)
Although palliative care programs are present in many large hospitals, access and dissemination of the advances taking place in the field of palliative care to patients living in rural communities have been limited. Patients may receive care from palliative care specialists and return home to communities with vastly different resources. Challenges for rural clinicians include collaborating with colleagues in primary palliative care, developing sustainable business and clinical models to support delivery of complex care, and ensuring effective transitions of care across all settings. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Lyn Ceronsky Source Type: research

Go Fish! Formative Feedback on the Communication Conundrum (TH313)
A “fishbowl” is an active learning technique that allows learners to problem-solve in a culture of safety. This session promises three things: 1.) You will learn what a fishbowl activity is and how to pull it off; 2.) You will learn about communication skills in the face of serious illness; and 3. ) You will have SO much fun doing numbers 1 and 2! Join us as we explore an innovative teaching technique that you can duplicate in your own practice! (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kathryn A. Walker, Mary L. McPherson, Christopher D. Kearney Source Type: research

Panacea or Pandora's Box? Immune Checkpoint Inhibitors and Palliative Care (TH314)
Over the past several years, a wave of new cancer immunotherapy agents referred to as immune checkpoint inhibitors (ICIs) have transformed the standard of care for patients with cancer. ICIs are most commonly used in advanced cancers with palliative intent and recently as frontline therapy for some cancers. These new agents have been shown to extend overall survival (OS) and progression free survival (PFS) in patients with lung cancer, melanoma, Hodgkin lymphoma, renal cell carcinoma, urothelial carcinoma, Merkel cell carcinoma, head and neck cancer, and more. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Chad Glisch, Laurel J. Lyckholm, James B. Ray, Yuya Hagiwara Source Type: research

SIMplifying Palliative Extubations: A Two-Part OSCE in a Simulation Center to Assess Entrustable Professional Activities (EPAs) in Hospice and Palliative Medicine (TH315)
Healthcare professionals require education and practice to master their communication and procedure skills, especially in potentially distressing circumstances such as palliative extubations. Palliative extubation refers to removal of mechanical ventilator support when, based on an individual's goal of care, it is thought to be prolonging the dying process rather than helping to support through a reversible illness. Removing the endotracheal tube will allow a natural death to occur. In order to provide competent and compassionate care for patients and family members before, during, and after a palliative extubation, health...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Megan E. Rau, Susan E. Cohen Source Type: research

Dying at the Margins: Reflections on Justice and Healing for Inner-City Poor (TH316)
Those challenged by economic and racial barriers suffer more than the rest of us —in life and death. Many patients who live and die at the margins experience mistrust and disempowerment as they navigate serious illness and the complexity of the medical systems that care for them. This presentation will describe how the intersection of racial and economic disempowerment with dy ing creates burden and suffering that is difficult to imagine. It also delineates how patients and families draw on social and spiritual capital to develop resilience and strategies for coping. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: David W. Moller, Diane E. Meier, Robert M. Arnold, Timothy E. Quill, Shirley A. Otis-Green, Tammie E. Quest Source Type: research

Making Measurement Matter: How Will Your Organization Engage with the New Palliative Care Quality Collaborative? (TH317)
All people living with a serious illness deserve high-quality care focused on their own priorities and values. Yet, palliative care is not available for all who could benefit, and measurement and improving care in the context of the proliferation of requirements to measure quality from health systems, payers, and accrediting bodies can challenge busy organizations. To assist palliative care programs in improving the availability and quality of care, AAHPM leads an effort to create a unified registry to track the prevalence of palliative care programs and measure the quality of program operations and clinical care delivery....
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Arif H. Kamal, Maggie Rogers, Joseph D. Rotella, Steven Pantilat Source Type: research

Palliative Care for Chronic Lung Disease: It Really Does Take a Village (TH318)
Chronic lung disease is the fourth leading cause of death in the United States and third leading cause of death worldwide. Patients often live for years with reduced quality of life and significant distress related to symptoms, stigma, reduced functional capabilities, social isolation, and complicated self-management protocols. Evaluating the potential benefits of advanced life support and bronchoscopic or surgical interventions can be daunting, even for actively involved patients. The World Health Organization's GOLD Guidelines recommend pulmonary rehabilitation (PR), a 6- to 8-week course of exercise training, education,...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: DorAnne Donesky, Julie J. Howard, Jessica Zitter Source Type: research

Bilateral Renal Agenesis: Redefining Pediatric Palliative Care Across an Innovative Complex Chronic Care Continuum (TH319)
Bilateral renal agenesis has historically been described as “incompatible with life” as chronic anhydramnios results in pulmonary hypoplasia, leading to respiratory failure at birth. Recent reports have detailed the survival of infants with renal disease and severe oligo-/anhydramnios following prenatal serial amnioinfusions as a bridge to neonatal dialy sis with the goal of pediatric kidney transplant. Subsequently, clinical trials have proposed treating fetuses with bilateral renal agenesis with serial prenatal amnioinfusions to allow for pulmonary maturation and the potential for long-term survival. (Source:...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Christopher A. Collura, Renee Boss, Megan Thorvilson, Brenda M. Schiltz Source Type: research

When Opioids Are Not the Answer: Using the ‘PARTNERS’ Framework to Manage Chemical Coping in Cancer Patients (TH320)
Pain is common in patients with cancer, and opioids are recognized as effective treatments for moderate to severe cancer pain. Yet as Cicely Saunders first recognized in her concept of “total pain,” there are non-physical dimensions to suffering, and these are not adequately addressed with opioids. Existential suffering or emotional pain occurs when severe illness injures a patient's identity, sense of purpose, spiritual faith, or relationships with others and causes anxiety a bout death or an uncertain future. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Amy A. Case, Eric Hansen, Michelle Walter, Marcin Chwistek, Luann Stevens, Megan Pailler, Joseph Arthur Source Type: research

When Calling 911 Is the Answer: Leveraging Resources in EMS to Deliver Emergency Hospice and Palliative Care (TH321)
A distressed call to EMS from families or caregivers of hospice patients in crisis can significantly alter end-of-life care. Hospice patients may have acute symptom management needs exceeding their resources at home, but may not desire to go to the emergency department (ED). However, traditional EMS protocols may not align well with hospice patients' goals of care. While EMS may be able to administer controlled substances in the home setting, this usually requires the patient to then be transported to the ED for further treatment. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Justin K. Brooten, Lisa Evans, David Wang, Joanne G. Kuntz, Crystal T. Wilfong, Jennifer Price Source Type: research

Does Advance Care Planning Actually Reduce Hope in Advanced Cancer? (TH322A)
One of the principal reasons providers cite for deferring advance care planning (ACP) is fear of “taking away hope” from patients. However, research is lacking on the relationship between ACP and hope in advanced cancer. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Michael Cohen, Andrew Althouse, Robert Arnold, Edward Chu, Douglas White, Yael Schenker Tags: Paper Sessions Source Type: research

The Process and Impact of a Stakeholder Driven Adaptation of the Serious Illness Conversation Guide for AYAs and Parents of Children with Serious Illness (TH322B)
Early conversations about advance care planning (ACP) are associated with better outcomes for seriously ill adults. Despite a parental desire for earlier and more ACP, large scale adoption of ACP for seriously ill children, adolescents, and young adults (AYAs) remains unrealized. There are few rigorously developed interventions to support clinicians in pediatric ACP communication to ensure care is aligned with family goals and values. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Danielle DeCourcey, Lindsay Partin, Anna Revette, Rachelle Bernacki, Joanne Wolfe Source Type: research

Development and Validation of the ACP-CAT for Assessing the Quality of Advance Care Planning Communication (TH322C)
High quality advance care planning (ACP) discussions are important to ensure patient receipt of goal-concordant care, however there is no existing tool for assessing communication quality in ACP encounters. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jacqueline Yuen, Amy Kelley, Laura Gelfman, Elizabeth Lindenberger, Cardinale Smith, Robert Arnold, Brook Calton, Jane Schell, Stephen Berns Source Type: research

The Patient Dignity Question in Routine Palliative Care Consultation: Implementation and Implications (TH322D)
The Patient Dignity Question (PDQ) is a validated psychometric tool designed to assess priorities and stressors relevant to care planning at all stages of illness. Administration of the PDQ has been demonstrated to improve patient and provider perceptions of empathy and communication. The PDQ has been tested in various settings, but never routinely as a component of palliative care consultation. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Rachel Hadler, Matthew Goldshore, Judith Nelson Source Type: research

‘Rehab’ vs Hospice, Let's Seriously Talk; Can Jack Weight-Bear, Will Jill Walk? The Impact and Benefit of Sponsored Physical Therapy Consults for Hospice Enrollees (TH323A)
Medicare covered inpatient rehabilitation ( “rehab”) is a common, and often appealingly expeditious, hospital discharge plan for older patients, despite the fact that many of these people have little capacity to participate in (or gain benefit from) this enterprise. In the past, “rehab” vs hospice enrollment was the frequent choice fa cing patients and families. For the past three years our hospice organization has encouraged our clinicians to utilize the physical therapy division of our visiting nurse sister service to reduce the dichotomy of these two alternatives. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Charles Newton Source Type: research

30-Day Readmission Reduction for Skilled Nursing Facility Readmissions at an Urban Medical Center (TH323B)
Unplanned 30-day hospital readmissions are an important measure of hospital quality and a focus of national regulations. The readmission rate for patients being discharged to skilled nursing facilities (SNF) has been an area of improvement for all healthcare systems. The vast majority of SNF will receive a penalty on their Medicare payments for fiscal year 2019 for poor 30-day readmission rates back to hospitals. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Nidhi Shah Source Type: research

Design and Evaluation of a Pilot Palliative Care Program in the Skilled Nursing Facility (TH323C)
The number of residents in skilled nursing facilities is expected to grow substantially over the next decade. Most SNF residents have serious illnesses that would benefit from Palliative Care intervention but reported data and understanding of best practices are lacking. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mina Chang, Cheryl Rathje, Haley Sawamura, Jenelyn Lim, Summer Verhines, Neelu Mehra Source Type: research

A National Pilot of Goals of Care Conversations for Seriously Ill Veterans: Patient and Site Variation and Associations with Bereaved Family Survey Outcomes (TH323D)
We examined patient characteristics associated with GoCC and the association of GoCC with Bereaved Family Survey (BFS) data on end-of-life quality. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Marie Haverfield, Ariadna Garcia, Joseph Rigdon, Karleen Giannitrapani, Anne Walling, Derek Boothroyd, David Bekelman, Natalie Lo, Jill Lowery, Mary Beth Foglia, Lisa Lehmann, Karl Lorenz Source Type: research

The Practice of Palliative Medicine in Developing Countries —Part One (TH330)
Please join AAHPM's International Scholars for a panel discussion. Each scholar will present for 10 –15 minutes on the state of the practice of palliative care in their home country, with an emphasis on the roles of physicians, nurses, and other healthcare providers; the status of education and research in the field; and the unique challenges facing patients and providers. There will be time all otted after each presentation to field questions and dialogue from the audience. Prepare to be educated and inspired by these accomplished individuals who are leading and advancing the field of hospice and palliative medicine...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Geoffrey Manda, Sunita Panta, Nasreen Muhammad Saleem, Tashi Dendup Wangdi Source Type: research

PC-FACS: A Year in Review (TH331)
PC-FACS, the highest-rated member benefit of the American Academy of Hospice and Palliative Medicine, offers busy clinicians an efficient way to stay on top of pertinent literature in a field that is growing exponentially. Now in its 12th year, PC-FACS —published in the Journal of Pain and Symptom Management and delivered in a convenient format to the email box of Academy members—provides topical summaries of just published research from more than 100 journals that are not specifically dedicated to hospice and palliative medicine and might not otherwise come to the attention of our readership. (Source: Journal ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mellar P. Davis, Robert M. Arnold Source Type: research

Advancing Palliative Nursing Leadership and Professional Development (TH332)
In the next 10 years, the number of patients with serious illness will continue to rise. In order to care for these patients, specialty palliative nurses are essential to lead in ensuring access to quality palliative care. Many clincians lack understanding of the necessary professional development for specialty practice and the linking to leadership. This session will provide an overview of qualifications of specialty palliative nursing practice and identify the areas for palliative nursing leadership. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Marika Haranis, Constance Dahlin Source Type: research

STAMPing Out Antimicrobial Doubt: Collaborative Decisions on End-of-Life Transitions of Care (TH333)
Transitions of care at end-of-life create opportunities for hospice plan of care development. Infections may be present at time of hospice admission or may trigger a transition of care (for example from home to general inpatient care, or hospital to long-term care facility when home is not yet appropriate). Hospice clinicians can interact directly with partner providers at these points of transition, facilitating a patient-centered team approach to decision making. Additionally, patients and caregivers may be more agreeable to modifying infection management treatment plans when a change in level of care is being considered...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Molly R. Sinert, Julie Ann Justo Source Type: research

The Billing Boys Tell All: Preparing to Succeed with Medicare and the Billers at Home (TH334)
Palliative Care (PC) programs are growing nationally. Once niche services well under the fiscal radar, many PC programs now have seven-figure budgets and a dozen or more clinicians. As programs cost more, sponsoring institutions' expectations for clinical revenue grow, leaving PC team members working longer hours to see more patients to help close the yawning budgetary gap. Most PC providers have become accustomed to basic billing and coding practices, but significant opportunities exist, even for seasoned clinicians and program leads, in the rapidly expanding array of billing revenue opportunities. (Source: Journal of Pai...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Christopher Jones, Phillip E. Rodgers Source Type: research

They Said What!? Navigating Conflict with Colleagues Across Specialties (TH335)
A core tenet of Hospice and Palliative Medicine (HPM) is effective communication. While HPM specialty education centers around communication with patients and families, effective communication with colleagues across specialties can be equally challenging. Given increased emotions, various communication approaches, and complexity inherent in caring for seriously ill patients, interpersonal conflict (IPC) between HPM providers and other healthcare team members is not uncommon. IPC is defined as someone experiencing negative emotions due to the perception of disagreement or impediment from another healthcare provider. (Source...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Ethan Silverman, Sara K. Johnson, Jasmine Hudnall, Anne Kelly, Andrew O'Donnell Source Type: research

Teaching Cross-Tolerance for Patients with Opioid Use Disorder Across Settings (TH336)
Palliative care practitioners are increasingly treating patients with comorbid opioid use disorder (OUD), yet guidance is lacking for managing pain in this population. Historically, palliative care clinicians have liberally prescribed opioids to patients with limited prognosis. As medicine has evolved, patients with chronic illnesses, even metastatic cancer, are living longer thanks to immunotherapies and other novel treatments. Thus, palliative care patients are at greater risk of both developing OUD and/or chemical coping while receiving intensive treatments. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Anessa Foxwell, Tanya J. Uritsky, Eleanor Anderson, Rachel Boris Source Type: research

My Pediatric Palliative Care Patient with a DNR Is Going to the Operating Room —Questions to Ask the Anesthesiologist (TH337)
Children with end-stage illness may have DNR orders, which limit common operating room interventions such as intubation, administration of vasoactive medications, and CPR. However, many of these children may still benefit from surgeries, imaging, or other interventions requiring anesthesia, such as radiation therapy to palliate metastases, long-term central venous access for medications or parenteral nutrition, gastric tubes, or pleura or paracentesis to help with breathlessness or abdominal distension. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sydney Brown, Chris Feudtner Source Type: research

When You Know Less Is More But Need the Patient and Family to Buy In: Using SPIKES for Deprescribing (TH338)
In the United States, the population above 65 years old in 2010 was 13%, and is estimated to be 20% by 2030, and more than 30% in other developed countries by 2030. With the rise of polypharmacy and multi-morbidity in the aging population, polypharmacy has been shown to be associated with an increased risk for adverse drug events, hospitalizations, and falls. Deprescribing is a systematic approach to withdraw or dose reduce medications considered inappropriate in an individual. The American Geriatrics Society has provided an update to the Beer's Criteria in 2019 to guide identification of inappropriate medications in the e...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sandra DiScala, Shaida Talebreza, Ashlei W. Lowery, Ella H. Bowman, Neris Palunas, Tsewang Ngodup Source Type: research

Grief and Bereavement Support for Families and Healthcare Professionals as Part of Integrated Care in Pediatric/Neonatal Intensive Care Units around the World (TH340A)
Grief and bereavement support (GBS) is important for the wellbeing and functioning of patients, families, and healthcare professionals (HCPs) and is part of the Integrated Model of Care (IMOC) in which ICU personnel address critical and palliative care (PC) needs concurrently. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Michelle Grunauer, Gabriela Bustamante, Kevin Zambrano Tags: Paper Sessions Source Type: research

Prognostic Awareness in Caregivers of Adults with Incurable Cancer (TH340B)
Caregivers' understanding of their loved ones' prognosis is important in helping patients make informed decisions about care. While patients' prognostic awareness is associated with their psychological distress, data are lacking on whether this relationship exists for caregivers. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Tamryn Gray, Deborah Forst, Ryan Nipp, Joseph Greer, Jennifer Temel, Areej El-Jawahri Source Type: research

End-of-Life Experiences for Children with Complex Chronic Conditions and Their Bereaved Parents: Perspectives on Preparedness (TH340C)
Children with complex chronic conditions (CCC) are assisted with technology and receive intensive medical care throughout their lives, resulting in unique end-of-life (EOL) needs. Parent perspectives are necessary to improving care, yet little is known about the lived experience of parents of children with CCC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jori Bogetz, Anna Revette, Abby Rosenberg, Joanne Wolfe, Danielle DeCourcey Source Type: research

Experiences of Family Caregivers Providing Support to Individuals Who Voluntarily Stop Eating and Drinking (VSED) to Hasten Death (TH340D)
Voluntarily stopping eating and drinking (VSED) is a method for individuals with serious illness to control the timing and means of their death. The process requires clinical and social support, but no research has investigated the experience of caregivers supporting someone through VSED. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jane Lowers, Nancy Preston, Sean Hughes Source Type: research

A Quality Improvement Project to Provide Early Referral to Palliative Care Clinic for Advanced Oral Cancer Patients (TH341A)
Recent literature affirms the benefits of early palliative care in advanced cancer patients. The prevalence of oral cancer is high in India and often patients present at advanced stages at the time of diagnosis. Bleak scope of curative treatment and high symptomatic burden detracts from the quality of life of these patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Aanchal Satija, Karl Lorenz, Michelle DeNatale, Jake Mickelsen, Odette Spruijt, S.V.S. Deo, Sushma Bhatnagar Source Type: research

Designing an Electronic Point-of-Care Dashboard to Support Serious Illness Clinical Visits: A Multi-Stakeholder Coproduction Project (TH341B)
Healthcare system complexity interferes with effective communication and goal-aligned services for people living with serious illness and their caregivers. Coproduction, a framework for healthcare service production involving real partnership between patients, caregivers, and care teams, may help. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Matthew Wilson, Aricca Van Citters, Inas Khayal, Catherine Saunders, Cathy Ross, Stephanie Tomlin, Amelia Cullinan, Meredith MacMartin, Megan Holthoff, Shoshana Hort, Amber Barnato, Kathryn Kirkland Source Type: research

A Quality Improvement Project on Documentation of Changes in Code Status Using the Electronic Medical Record (EMR) in Pediatrics (TH341C)
In order to provide gold standard patient centered care, discussions regarding advance care planning are essential for patients with serious illnesses. In 2018, a new law was enacted in our state requiring documentation of code status conversations in the inpatient EMR for any code status other than “Full Code.” Prior to this law, many code orders were changed without documentation or adequate communication to incoming providers. Since there was little to nothing documented, parents were being asked to have the same conversation repeatedly and either starting to doubt their decisions or sen sing the lack of com...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jessica Casas, Joy Hesselgrave, Amy Jeppesen, Leah Peters, Laura Loftis, Nick Ryan Magdoza Source Type: research

Impact of Combining a Code Status Order with Admission Orders for Patients Admitted Through the Emergency Department. (TH341D)
Some have argued that Emergency Physicians (EPs) lack the time, skills, and rapport to effectively engage patients in code status (CS) discussions. And some have claimed that EPs default to full treatment regardless of patient preference. However, identifying patients' code status preference prior to admission can expedite the alignment of treatment with patients' goals of care. In April 2017 we added a mandatory code status order (CSO) for all admissions requested by EPs. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Daniel Miller, J. Priyanka Vakkalanka, Morgan Swanson, Andrew Nugent, Timothy Thomsen, Yuya Hagiwara Source Type: research

State of the Science in Pediatric Palliative Care (TH351)
With the growth of Pediatric Palliative Care, it is essential for practitioners to find ways to stay current on the most recent literature. In the spirit of the State of the Science plenary, which is part of each Assembly, and the prior State of the Science in Pediatric Palliative Care, the presenters will endeavor to review the literature published since January 2019, which should inform the practice of Pediatric Palliative Care. This annual and highly regarded session includes an interdisciplinary team of co-presenters with representatives from medicine, nursing, social work, psychology, and chaplaincy and will look at t...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Katharine E. Brock, Toluwalase A. Ajayi, Kevin Madden, Sarah McCarthy, Maggie C. Root, Caitlin Scanlon, Daniel Webb Source Type: research

Experiences of LGBT Patients and Family Members with Hospice and Palliative Care (TH352)
The lesbian, gay, bisexual, and transgender (LGBT) community experiences discrimination and stigma in accessing health care and social services – including palliative, hospice, and long-term care. Health care providers may fail to recognize or address disparities in care. Providers and institutions may be uncomfortable with sexual orientation and gender identity and expression issues, and often don't inquire about these. Research shows th at LGBT patients fear being open about their identities, not receiving equal or safe treatment, and having their family of choice and designated surrogates disrespected or ignored b...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Cathy Berkman, Noelle Marie Javier, Andrew Lawton, Shail Maingi, Sean O'Mahoney, Gary Stein Source Type: research

Assembly Book Club: Discussion of the Book Just Medicine: A Cure for Racial Inequality in American Health Care (TH353)
Session leaders will be assigned to each table to start and facilitate discussion. This will help to ensure that each table is having a productive dialogue. Conversation-starting questions will be provided at each table and have been vetted by the Humanities and Spirituality SIG. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Chandana Banerjee Source Type: research

Leading with Compassion (TH354)
Palliative and hospice care are fundamentally compassion-centered practices. At the same time,  clinicians often face challenges to maintaining their compassionate centers in the face of complex patient/family dynamics and importantly, with each other in stressful care environments. This presentation will engage participants in self-reflection about personal leadership style and will provid e specific, actionable strategies to develop as a compassionate leader, to embed compassion practices in the workplace, and to support and drive change management to provide compassion-centered care. (Source: Journal...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Joanne Reifsnyder Source Type: research

AAHPM Leadership Forum: Ignite —More Paths to ‘Yes’ in Leadership Conversations (TH360)
AAHPM's Leadership and Career Development Committee and Leadership Forum is excited to bring an Ignite session to the concurrent platform. There are many nuanced skills in leadership. One of those skills is conversations to advocate for the needs of your program, your team, or yourself. While we in HPM pride ourselves in the art of difficult communication, somehow the communication skills that bring us success with patients fall flat in the board room. In this concurrent session, we will identify the most common strengths found in HPM leaders and the strategies in leadership conversations that capitalize on those strengths...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kathleen Neuendorf, Tammie E. Quest, Christina Rowe Source Type: research

Meeting the Hospice and Palliative Care Registered Nurse Workforce Challenge: Hospice Nurse Residencies as a Case Study (TH362)
Hospice organizations in the United States continue to see dramatic growth in patients served annually, nearly doubling growth between 2004 and 2014. Palliative care services have also significantly increased across the country with now close to 30% of counties and 70% of hospitals across the United States offering palliative care. In order to respond to this growth and the rapidly aging population, hospice and palliative care organizations must maintain a vibrant hospice and palliative registered nurse workforce. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Susan Lysaght Hurley, Constance Dahlin, Nadia Soulouque Source Type: research

Artificial Intelligence, Machine Learning, and Digital Therapeutics in Palliative Care and Hospice: The Future of Compassionate Care or Rise of the Robots? (TH363)
Palliative care finds itself in a conundrum. Our field is rapidly growing, and yet in the coming decades, the need for palliative care and hospice will far outpace the number of specialist clinicians available to provide it. Hence, it is imperative that we develop novel care delivery models in the present to address the needs of our future patients. Digital therapeutics and artificial intelligence represent two innovative means to help extend the reach of palliative care and hospice. Digital therapeutics (DTx) represent an expanding field of evidence-based healthcare interventions that utilize everyday technology, such as ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mihir Kamdar, Joshua Lakin, Haipeng Zhang Source Type: research

Breaking Access and Distance Barriers: Using Innovative Modalities of Tele-Palliative Care (TH364)
Patients suffering from incurable and debilitating conditions are in crucial need of interprofessional palliative care services. Palliative care teams monitor, manage, and maintain such patients' performance status while improving symptoms and facilitating goals-of-care discussions. A growing workforce shortage in palliative care professionals as well as access issues in remote areas are significant barriers to patient-centered, serious illness care. Efforts to bring palliative care interprofessional expertise to patients in the community have proven successful in increasing early goals-of-care discussions, improving compl...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sandra E. Sanchez-Reilly, Katharine L. Cheung, Kimberly Shea, Anjuli Vasquez Source Type: research

New Drugs and Drug News: The 411 and Implications for Palliative Care (TH365)
Up to 100 new drugs and dosage formulations are approved every year by the Food and Drug Administration (FDA). Some of these are new molecular entities, while others are new formulations, new indications, generic drug approvals, or labeling revisions. Even if a drug is a “new” molecular entity, it may not be “improved” over molecular entities already commercially available. In caring for patients with advanced illnesses, practitioners must make prudent drug therapy choices. Part of this decision-making process is a careful assessment of the burden-to-benefit ratio, including the financial burden of ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mary Lynn McPherson Source Type: research

To Forgo or Not to Forgo: Nutrition and Hydration in a Child Perceived to Be Suffering Inordinately by Parents (TH366)
The American Academy of Pediatrics (AAP) has deemed forgoing medically administered nutrition and hydration (MANH) for pediatric patients ethically acceptable in selected circumstances, when there is consensus that the provision of fluids and nutrition do not confer a net benefit to the child. The practice, for instance, might be permissible for a child who permanently lacks awareness and ability to interact with the environment or a child in the dying process for whom nutrition/hydration simply may prolong and add morbidity. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sara Taub, Robert C. Macauley, Fernando F. Serna, Douglas S. Diekema Source Type: research

Lessons from a Therapist's Chair: Optimizing Palliative Communication Through Psychotherapy Best Practices and Skills (TH367)
The use of communication as a therapeutic tool is an essential piece of both palliative medicine and psychotherapy. The approach with which communication is conceptualized and taught, however, is markedly different between the two fields. In hospice and palliative medicine training, we often teach generalized communication tools and strategies. By contrast, communication training in the psychotherapy setting hinges upon the concept of case formulation. A case formulation is a conceptualization of the unique core psychological issue a patient or family may be struggling with. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Danielle M. Chammas, Keri O. Brenner Source Type: research

Not Lost in Translation: Ensuring LGBTQ+ Inclusion in the Palliative and End-of-Life Clinical-Translational Science Spectrum (TH368)
Sexual and gender minority groups living in the United States experience disproportionate rates of serious and life-limiting illness compared with non-minority counterparts. While LGBTQ+ patients and caregivers share similar serious illness and end-of-life (EOL) coping and support needs with non-minorities, they also face additional burdens and uncertainties: provider bias and discrimination, identity and relationship disclosure, acknowledgment of chosen family, and access to safe and affirming care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kristin G. Cloyes, Kimberly D. Acquaviva, Carey B. Candrian, Kate L.M. Hinrichs, Tarynn M. Witten Source Type: research

Addressing Global Health Disparities with the Development of a Palliative Care Exchange Program (TH369)
Even countries with robust palliative care programs struggle to offer services to every terminal patient. It's easy to imagine how countries without a substantial program are profoundly challenged. The 2015 Quality of Death Index found that 0.6% of Ecuadorians who qualified for palliative care services actually received them, compared to 52% of Americans. The Index credits these health disparities to limited education, scarce availability of opioids, weak national policy, sub-optimal healthcare spending, and limited community engagement. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Linda Quinlin, Wendy G. Schmitz, David Small Source Type: research

Keeping It Down: A Case-Based Approach to Managing Pediatric Nausea and Vomiting (TH305)
Nausea and vomiting are significant distressing symptoms among children receiving palliative or hospice care due to a variety of potential causes. In many situations children are unable to adequately express their specific discomfort. Most antiemetics block one or more of the receptors involved in the pathophysiology of nausea and vomiting; however, no antiemetic blocks all possible receptors. Unfortunately, the first anti-emetic chosen is often inadequate to manage the patient's nausea and vomiting. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Melissa Hunt, Lisa Humphrey Source Type: research