The Journey of Purple Butterfly (QI603)
Approximately one-third of the deaths in the United States occur in hospitals (Hall, Levalnt& Defra, 2013). While some patients chose aggressive interventions until the end, others decide to transition to comfort care measures. In 2018, 15% of patients referred to Palliative Care Services at New York-Presbyterian Lower Manhattan transitioned to comfort-oriented measures and passed away during that hospitalization. Prior to improvements, there was no standardized communication tool to alert staff of the presence of a patient on comfort measures prior to entering the room. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Anna Krakowski, Jessica O'Brien, Kevin Xuereb Source Type: research

A Quality Improvement Project Using Lean Tools to Improve Hospice Utilization in a Veterans Affairs Institution (QI604)
Shorter hospice stays are related to lower quality of end-of-life care, poorer symptom management, and burdensome, low-value care. The VA Long Beach Healthcare System had a low hospice utilization and a hospice median length of stay (LOS) of 10 days, half the median VA average. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kevin Wei, Rebecca Yamarik, Samuel Baz Source Type: research

Leveraging Payment Reform to Implement Sustainable Depression Screening and Treatment (QI605)
Two Medicare payment reform initiatives, the Oncology Care Model (OCM) and the upcoming mandatory Radiation Oncology Model, require and financially support depression screening for patients with cancer who are receiving active treatment. As a result, cancer providers across the country have a need to expand depression screening and treatment. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Gabrielle Rocque, Laquetta Allen, Trevor Lever, Jordan DeMoss, Terri Salter, Chao-Hui Huang Source Type: research

Improving Palliative Care Chaplain Communication with the Interdisciplinary Care Team Through Implementation of the SBAR Technique (QI606)
As an interdisciplinary member of a palliative care team, chaplains provide critically ill patients with an extra layer of spiritual and emotional support. Chaplains provide counseling on sensitive matters such as end-of-life discussions and ethical decision-making. The chaplains document these important conversations in the electronic health record. However, oftentimes, this key information is not written in a format or with language that is well understood by the interdisciplinary medical team. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Karen Steinhauser, Jessica Beliveau, Artie Hendricks, Kristen Lakis Source Type: research

Utilizing Shared Medical Appointments to Increase Advance Directives Discussion and Documentation (QI607)
Advanced care planning and ADs are part of routine patient care. SMAs are clinical visits in which a group of patients, sharing a common illness or demographic, meet with providers in a unified session, with the goal of discussing relevant issues in a safe environment. SMAs can also be implemented for discussions regarding goals of care, such as advanced care planning, which is often a difficult conversation to broach. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Chelsea Garcia, Jennifer Gomez, Orly Hadar, Annie Gupta, Alfred Kokwaro, Nydia Martinez, Diana Galindo Source Type: research

Difficult Conversations —An Academic Intervention to Enhance Physician Communication (QI608)
Resident physicians are often faced with difficult conversations regarding prognosis, code status, transition to palliative care, and conflict. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Chelsea Garcia, Linda Godinez, Annie Gupta, Orly Hadar, Nydia Martinez, Darby Sider Source Type: research

Using Frailty to Trigger Palliative Care Referral for Patients with Heart Failure (QI609)
Heart failure (HF) often comes with high symptom burden and increased morbidity and mortality. Because the trajectory of HF is difficult to predict, however, the opportunity to refer patients to palliative care (PC) to clarify care preferences is often missed. Patient frailty is strongly associated with poorer prognosis and, thus, might be a useful trigger for referral of HF patients to PC for timely advance care planning. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Monique Neault Source Type: research

Creation and Implementation of a Palliative Sedation Policy: Foundational Aspects and Lessons Learned (QI610)
The goal of palliative care is to provide optimal quality of life for persons with serious illnesses. Nearing end of life, refractory physical symptoms are devastating. These are associated with complicated grieving, posttraumatic stress disorder (PTSD), and staff compassion fatigue. In some cases, PS is appropriate but no such PS policy existed for our palliative care team and local VHA facility. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sarah Gillespie-Heyman, Shelli Feder, Tracy Shamas Source Type: research

Legacy Work: Assessing the Impact on Families and Staff in the Hospital Setting (QI611)
Legacy work (LW) refers to interventions that provide memory making at the end of life. Memory stone (MS) making has been a form of LW used at our institution for over 4 years whereby patients' fingerprints are placed onto glass stones and given to loved ones. LW is a powerful tool that creates meaning for patients, families, and staff, allowing everyone to honor each patient's humanity as well as their own. The impact of MS making has never been evaluated and its meaning to families/staff has never been measured. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jessica Bullington, Elizabeth Higgins Source Type: research

Bringing Home into the Academic Medical Center: Inpatient Hospice with a Community Partner (QI612)
Often, patients with devastating and serious illnesses are referred to academic medical centers for expert-level care. After evaluation, many patients and families elect comfort care, and patients spend the final days of their lives within an academic center's hospital walls. There were not options for inpatient hospice care in our area, and a review of our process showed inconsistent end-of-life care processes and bereavement support. Literature shows that including palliative care treatment plans at the end of life can reduce patient suffering. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kencee Graves, Holli Martinez, Lorie Nielson, Dave Leavitt, Liza Johnson Source Type: research

Partnering with the Hospital QI Team to Improve Palliative Care Delivery in Intensive Care Units (QI613)
Boston Medical Center (BMC), a 514-bed safety-net academic medical center, has 12% of beds dedicated to adult intensive care. Impacts of palliative care (PC) on reducing costs and nonbeneficial ICU treatments are well documented; however, barriers remain in palliative care delivery in ICUs. Prognostic uncertainty and “siloed” care contribute to fragmented communication regarding goals of care in ICUs. Objective assessment of patients' risk factors, including mortality risk, can enhance clinical decision-making and communication. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Alexandra Dobie, Shrenik Jain, Amy Cann, Jessica Knight, Perla Macip-Rodriguez, Henri Lee, Sandhya Rao, James Moses Source Type: research

Let's Bring Pain Rating Up to Scale (QI614)
Accurate pain assessment is difficult in children with neurological impairment because their manifestations of pain are often atypical. Delay in identification of discomfort leads to decreased quality of care. The Individualized Numeric Rating Scale (INRS) is a pain assessment tool developed at BCH for use with children>6 years with severe neurological impairment. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Nicole Fernandez, Marc-Antoine Marquis Source Type: research

Improving Nurse Knowledge and Confidence in End-of-Life Care Utilizing the End-of-Life Nursing Education Consortium Curriculum: A Pilot Project (QI615)
Due to the sensitive nature of palliative care (PC), many nurses are overwhelmed by PC and underprepared to manage its intricacies. Because PC is a relatively new field, nurses who graduated in the past several decades likely did not receive any PC education. Despite recent inclusion of PC in undergraduate programs, coverage in textbooks is marginal. Faculty lack sufficient time and training to prepare nursing students to provide PC; this translates into nurses having insufficient preparation in PC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Rachel Huster Source Type: research

Evaluation of Palliative Care Coaching Sessions on Resident Physicians' Knowledge, Preparedness, and Frequency of Goals of Care Conversations (QI616)
A previously developed coaching intervention increased resident physicians' preparedness in discussing palliative care (PC) topics and improved rates of documented goals of care (GOC) discussions. Based on resident feedback, we focused on prognostication and posthospital discharge options in PDSA cycle 2 of this quality improvement (QI) initiative. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Rachel Rodenbach, Dio Kavalieratos, Zachariah Hoydich, Robert Arnold, Julie Childers Source Type: research

Standardizing the Documentation of Advance Care Planning Discussions (QI617)
ACP notes within the medical record are vital in communicating patient preferences among providers. A standardized note template helps ensure comprehensive documentation necessary to maintain a plan of care consistent with patient values across sites of care and throughout the illness course. Using a PDSA method, this project developed and pilot tested an ACP template in the Department of Geriatrics and Palliative Medicine at Mount Sinai. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Melissa Bakar, Rita Crooms, Priya Krishnasamy, Rachel Adams, Ankita Mehta Source Type: research

Identifying Important Palliative Topics and Communication Preferences Among ALS Patients (QI618)
ALS is a rapidly progressive, lethal neurodegenerative disease. Advanced care planning, palliation, and psychosocial needs must be discussed early. Literature recommends introducing palliation at dynamic points in a disease model clinic; however, this is not consistently practiced. There are no guidelines for when, with whom, or how palliation is discussed. Our QI study surveyed patients at our ALS clinic to assess their palliative needs and preferences. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Lalanthica Yogendran, Bianca Barcelo, Maria Dominique Mortel, Bradley Shane, Briana Ibarra, Catherine Johnston, Holli Horak, Katalin Scherer Source Type: research

GiTalk: A Novel Palliative Care Communication Curriculum for Gastroenterology Fellows (QI619)
Patients with gastrointestinal and liver disease have substantial unmet palliative care needs. Given limitations in the specialty palliative care workforce, it is imperative to develop interventions to improve primary palliative care skills among gastroenterology (GI) clinicians. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Amar Bansal, Zachariah Hoydich, Rene Claxton, Julie Childers, Robert Arnold, Dio Kavalieratos Source Type: research

Prospectively Identifying People for Goals of Care Conversations (QI620)
Our aim was to develop a method to prospectively target a population that is likely to benefit from goals of care discussions by first conducting a retrospective analysis of those dying in a large urban hospital system following recurrent admissions and escalating healthcare utilization. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Travis Klein, Brianna Burns, Mark Nelson Source Type: research

Impact of Team-Based Care Models: A Lean Six Sigma Strategy to Improve Palliative Team Effectiveness and Reduce 30-Day Readmissions (QI621)
Palliative care (PC) teams are increasingly called upon to improve outcome metrics such as reducing 30-day oncologic readmissions. PC teams typically face high patient volume and limited staffing, posing challenges to quality improvement initiatives related to the delivery of care. An LSS strategy is increasingly used in health care to better coordinate existing resources, enhance teamwork, and improve the value of patient care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sachin Kale, Aravind Chandrasekaran, Justin Kullgren, Taylor Moline, Christopher Hritz, Deborah Russell, Amir Mortazavi Source Type: research

Disposal of Opioid Medications after Death in a Palliative Care Setting (QI622)
Most palliative patients are prescribed opioids around the end of life. Misuse of opioids can cause harm, which can be minimized through disposal once they are no longer required. In New Zealand, the recommended disposal method is return to a pharmacy for destruction, however there is no standardized approach to educating family/carers regarding safe disposal methods. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Sam Strachan, Amanda Sommerfeldt, Yih Harng Chong, Laura Mulligan Source Type: research

Educating Nurses on Palliative Care Interventions for COPD Patients in a Medical Intensive Care Unit (MICU): A Quality Improvement Project (QI623)
Inadequate palliative care knowledge and lack of clarity on nurses' roles in palliative care have been identified as barriers for appropriate palliative care services for COPD patients. Although nurses have been identified as key palliative care providers, knowledge gaps regarding palliative care delivery and inadequate communication training have acted as obstacles to addressing patient palliative care needs. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mary Clare Houlihan, Judith Paice Source Type: research

Physicians' Knowledge of Medical Nutrition for Patients with Advanced Dementia (QI624)
Dementias are progressive and incurable, leading to a profound loss of cognitive function with a final phase characterized by reduced oral intake. The availability of medical nutrition has made treatment decisions more complex for surrogates, and despite studies and National Society recommendations to the contrary, many physicians continue to place feeding tubes in patients with dementia. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Priya Pinto, Jeannine Nonaillada, Jeffrey Berger Source Type: research

The Discomfort with Comfort Care Delivery in the Acute Hospital Setting: Is End-of-Life Care Education for Hospital Nurses Necessary? (QI625)
Death and dying is a complex medical process that affects not just the individual and their loved ones, but the health care providers and the medical system as well. Although the majority of Americans and those with serious illness prefer to die at home, most die in an institutional setting. Hospital nurses, with little experience with end-of-life (EOL) care, then become directly accountable for providing hands-on care and for advocating for appropriate end-of-life care. Thus, familiarity with basic comfort measures is an essential skill for all healthcare providers who are caring for patients whose death is imminent. (Sou...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Tiffany Gonzales Source Type: research

Outcomes of a PharmD-Led Palliative Care Interprofessional Team Learning Model (QI626)
An interprofessional palliative care training model can increase the number of palliative care practitioners and improve palliative care team collaboration. The PGY2 pain management and palliative care (PMPC) pharmacy residency director collaborated with a hospice fellowship director to create an interprofessional outpatient palliative care direct patient care teaching clinic. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Lauren Shirley, Sandra DiScala, Maura Farrell Miller, Shashi Bhandari, Lynnea Valpatic, Richard Levene, Michael Silverman Source Type: research

An Effective Strategy to Increase Advance Care Planning: Use of a Patient Video Decision Aid in Outpatient Heart Failure (QI627)
Nearly one in five patients admitted to the hospital for heart failure will die within 30 days of discharge. Despite this poor prognosis, most do not recall discussing end-of-life preferences with a healthcare provider. ACP helps to ensure that patients receive care that aligns with their goals and wishes and helps engage them in shared decision making in an ongoing and iterative process. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Janet Wulf, Carol Wade Source Type: research

How Long Will This Take, Doc? Timing from End-of-Life Orders Until Death (QI628)
Withdrawal of life-sustaining treatment (WLST) is a critically important time in the life of a patient and family and presents unique emotional pressure to all involved. The decision to redirect goals of inpatient care to focus on comfort is best supported by clear, evidence-based treatment. Use of an order set in the electronic health record (EHR) can facilitate best care for the dying patient. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Andrea Wetshtein, Brianna Burns, Charles von Gunten, Zach Rossfeld Source Type: research

Improving Palliative Care Delivery in the Medical Intensive Care Unit: A Quality Improvement Project (QI629)
Approximately one in five deaths in the United States occurs during or shortly after admission to the intensive care unit (ICU). Enhancing palliative care delivery in the ICU reduces length of stay (LOS), facilitates transition to lower acuity settings, and strengthens continuity of care. Our baseline data indicated that many patients who met triggers and survived the medical ICU (MICU) did not receive palliative care consultative services. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Jacqueline Sheehan, Kam Sing Ho, Charles Gaulin, Setareh Alipour, Gustavo Contreras Anez, Jennifer Fung, Christie Mulholland, Howard Arabelo, Janet Shapiro Source Type: research

From Simulation to Bedside: A Pilot Study to Measure Impact of Communication Skills Training Program (QI630)
There is a growing national mandate to train all clinicians in primary palliative care skills including serious illness communication. As a result, there has been extraordinary growth of programs to teach complex communication, but few studies to evaluate retention of skills acquired in training. At University of Massachusetts, internal medicine (IM) residents have a mandatory training in serious illness communication using simulation and patient actors. We designed a pilot to compare residents' performance in simulation versus real-life bedside encounters with hospitalized patients. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Vandana Nagpal, Majid Yazdani, Prashant Veerreddy, David Fish, Mary Philbin, Jennifer Reidy Source Type: research

Implementation of a Modified Memorial Symptom Assessment Tool in the Pediatric Palliative Care Clinic (QI631)
A major goal of pediatric palliative care is to improve patients' quality of life by decreasing their symptom burden. There is limited data on the prevalence of various symptoms in the general population of pediatric palliative care patients followed in the clinic setting. In addition, there is no single tool that is being used consistently across multiple institutions. Without the use of a standardized approach, patients and parents often underreport symptoms and symptoms go untreated. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kimberly Bower, Krishelle Marc-Aurele, JoAnne Auger, Samantha Brown Source Type: research

National Institute of Nursing Research and MedlinePlus ® Team Up to Offer a Palliative Care Text Campaign (QI632)
Research has shown that patients who receive palliative care report improvement in pain, nausea, and shortness of breath; communication with their healthcare providers and family members; and emotional support. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Adrienne Burroughs, Alison Lemon, Stacy Coppess, Jeri Miller Source Type: research

The Feasibility of a Yoga Therapy/Mindfulness Program for Supportive Cardiology Patients (QI633)
Therapeutic yoga (TY) gently supports the body in therapeutic positions and may include relaxation breathing, comforting touch, and mindfulness meditation (MM). Evidence suggests that yoga, relaxation, and MM can help reduce anxiety, pain, nausea, and constipation. We piloted a feasibility project at a large New York teaching hospital to expand an established palliative care TY/MM program to include supportive cardiology patients. These are patients with advanced heart failure who are often awaiting (or have received) cardiac transplant, ventricular assistive devices, or total artificial heart support. (Source: Journal of ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Deborah Matza, Suzanne Goldhirsch, J.D. Elder, Emily Chai Source Type: research

Working Together: An Introduction to Palliative Care for the Medical Interpreter (QI634)
Approximately 63 million Americans speak a language other than English at home and yet, there is a paucity of research and growing interest in the topic of medical interpreters in palliative care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Komal D'Souza, Natsu Fukui, Helen Fernandez, Christie Mulholland Source Type: research

How to Meet the New 2019 ACGME Requirements to Incorporate Palliative and Hospice Medicine into a Teaching Community Hospital's IM GME Residency Program (QI635)
As of July 2019, the Accreditation Council of Graduate Medical Education (ACGME) requires IM GME programs to incorporate training in palliative and hospice medicine. Miscomprehension of the difference between palliative medicine and hospice is a barrier for IM residents' ordering appropriate PM consults for patients with chronic, nonmalignant disease. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Phyllis Macchio, Greg Haggerty, Martin Barnes, Carolina de Elia, Alan Kaell Source Type: research

Not All Fatigue Is Created Equal: The First Step of Palliative Symptom Management for Adults with Multiple Sclerosis (QI636)
Of the 2.3 million individuals globally with multiple sclerosis (MS), more than 80% struggle with MS-related fatigue, negatively impacting daily life, function, and quality of life. However, advancing research in this area is hindered by the lack of a consensus definition of MS-related fatigue. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Corey Lofton, Patricia Patrician, Yolanda Harris, Maria Shirey, Marie Bakitas, James Dionne-Odom Source Type: research

Patient-Driven Goals for High-Risk Hospitalized Patients (QI637)
Goals of care (GOC) discussions are not consistently occurring in hospitalized patients at high risk for rapid response activation (RRT) and intensive care unit (ICU) transfer, leading to unwanted ICU transfers. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kelly Pennington, Timothy Dempsey, Ann Vu, Courtney Stellpflug, Daniel Partain, Cory Ingram, Megan Dulohery Scrodin Source Type: research

Impact of an Advanced Care Management (ACM) Program within an Accountable Care Organization (ACO) (QI638)
As individuals with advanced illness approach end of life, there are often recurrent and costly hospitalizations that may be unaligned with their preferences for care. ACM provides a combination of community-based care coordination and advanced care planning to bridge curative and end-of-life care for patients with advanced illness. The ACM program created in collaboration with an ACO and Alivia served patients in the Jacksonville, FL, region and consisted of an RN and social worker providing home visits, staffed by a palliative medicine physician, with 24/7 afterhours coverage and paramedicine availability. (Source: Journ...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Connie Edelen, Marian Raftis, Faith Moorhouse Source Type: research

Improving Care for Patients with Advanced Kidney Disease: More, Earlier and Better Conversations Using the Serious Illness Conversation Guide (QI639)
Despite growing evidence citing benefits, advance care planning (ACP) conversations and advance directive (AD) completion remain low in patients with advanced kidney disease. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Laurel Kilpatrick, Catalina Sanchez Hanson, Mary Beth Callahan Source Type: research

Becoming a Spiritual Care Generalist: Spirituality Training for Palliative Care Fellows (QI640)
Despite palliative care's commitment to include spiritual care in patient care, research is lacking regarding competencies or methods for teaching spirituality to palliative care fellows. We developed a chaplain-led rotation to improve our training of palliative care fellows in the spiritual dimensions of care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Edward Penate, Joshua Hauser, Mark Bradley Source Type: research

What Can Your Pharmacist Do for You? Role of Collaborative Drug Therapy Management in Hospice (QI641)
American healthcare systems, including community-based organizations, are grappling with rising healthcare costs and medication-related expenditures. Annually, more than 1.5 million preventable adverse events are caused by inappropriate use of medications. This costs our healthcare system $290 billion annually. Rising drug costs and medication safety concerns provide a rationale for increased clinical pharmacist collaborative medication management, especially in the hospice setting. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Alifia Waliji-Banglawala, Stephanie Patel, Susan Lysaght Hurley, Patricia Condon Source Type: research

Working Smarter Not Harder: A Quality Improvement Project to Improve an Interdisciplinary Palliative Care Rotation (QI642)
As palliative care continues to grow, teams may be stretched with both increasing patient care loads and increasing interest from learners seeking experience in palliative care. Therefore, strategies are needed to provide effective palliative care education as efficiently as possible. Members of the interdisciplinary palliative care team at University of Iowa Hospitals and Clinics serve as co-preceptors for an average of 69 multidisciplinary learners per year. Because each discipline and level of learner has a different rotation length and schedule, we observed a need to repeat many teaching activities in a single month. (...
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kashelle Lockman, Yuya Hagiwara, Katey Kooi, Katie Ries, Ann Struve Source Type: research

Proactive Palliative Care for Hospitalized Primary Care Patients (QI643)
Early integration of PC improves outcomes for patients with cancer, including quality of life, symptom burden, and health care utilization. Strategies are needed to identify primary care patients who would benefit from early PC. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Samantha Shapiro, Cindy Lien, Mary Buss Source Type: research

Identifying Risks of Readmission in Patients with Dementia in SNF for Targeted Community-Based Palliative Consultation (QI644)
Dementia patients are at high risk for preventable hospital readmission. This population could benefit from expert consultation in SNF to reduce readmission rates. Community-based palliative medicine focusing on symptom management and goals of care in post-acute care facilities can lower unnecessary transitions, hospitalization, and emergency department visits; reduce length of stay; and lower Medicare expenditures. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Irma Duncan, Maria Cantu-Cooper Source Type: research

VetConnect: A Quality Improvement Program Delivering Palliative Care Services via Telehealth to Veterans Residing in Nursing Homes (QI645)
Beginning in June 2017, the VetConnect program launched, providing palliative, geriatrics, and mental health specialty care via telehealth to veterans in contracted community nursing homes (CNH) and state veterans nursing homes (SVHs) across Colorado and Oklahoma. This model of care allows for increased access to care for veterans who frequently have difficulty accessing specialty care services, as well as efficiency in healthcare delivery by reducing travel and wait times. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Anne Hale, Leah Haverhals, Rachel Johnson Source Type: research

A Bereavement Support Group for Caregivers: A Collaborative Effort (QI646)
Literature demonstrates family caregivers of oncology patients experience stressors and may benefit from psychosocial support. Many develop relationships with care teams and through participation in a caregiver support group (CSG). When their loved one dies, they no longer have contact with these supports. A bereavement support group (BSG) consisting of oncology and palliative care team members is one way to help address this gap. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Darlene Harmor, Sandra Sabatka Source Type: research

Creation of and Experience with the End of Life Plan of Care in the EMR: A Quality Improvement Project in the Pediatric Intensive Care Unit (QI647)
Lack of clear guidelines leading to physician variability in practice combined with inaccessible documentation for a child receiving comfort care at end of life (EOL) in our PICU resulted in communication breakdowns triggering moral distress amongst staff. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Mindy Dickerman, Juliana O'Brien, Carly Levy Source Type: research

How to Strategically and Successfully Expand a Palliative Care Initiative Hospital-Wide (QI648)
By eliciting and implementing final wishes for patients dying in the hospital, the 3 Wishes Project (3WP) has been shown to foster compassionate, patient- and family-centered care. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Danielle Bear, Peter Phung, Daniel Karlin, Patricia Jakel, Jessica Hainje, Kristen Hjelmhaug, Allegra Bell, Rebecca Bank, Gwendolyn Peterson, France Clarke, Deborah Cook, Thanh Neville Source Type: research

Improving Recognition of Frailty Syndrome and Clinical Self-Efficacy in Nurse Practitioner Students (QI649)
Frailty is a commonly used term in healthcare to describe a subset of the elderly patient population but there remains debate on how to identify and treat this syndrome. Advanced care planning is a key factor in treating the frail patient with hopes of slowing the progression of debilitation, including functional decline, polypharmacy, increased disability, and vulnerability. In addition, collaboration across healthcare disciplines remains a vital aspect in caring for and enabling positive outcomes for the frail individual and promotion of quality of life. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kristina Fortes Source Type: research

ED Provider-Based Palliative Care Electronic Notification: A Quality Improvement Initiative (QI650)
51% of adults older than 65 years of age are seen in the emergency department in the last month of their life. Many of those patients die in the hospital. Emergency medicine providers (EPs) speak to patients and families who may share a unique perspective on the patient's current quality of life. The emergency department also can set the trajectory of a patient's care. Early initiation of palliative has been shown to improve quality of life and reduce the costs associated with advanced aggressive treatments. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Lindsay Weaver, Ben Hunter, Ashley Satorius, Matthew Givens, Eashwar Chandrasekaran Source Type: research

Exploring the Needs of Palliative Care Caregivers in Rural India (QI651)
The nuclear family in India is shrinking but the burden of caregiving is growing. Traditional dependence on family members as caregivers leaves a gap where needs of caregivers and patients are not being met. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Kirsten Schlosser, Preeya Desh Source Type: research

Weekly Rounds with Interdisciplinary Palliative Care Consult Team and Prognostication for Hematology/Oncology Inpatients (QI652)
A growing body of evidence suggests that improving physician prognostication in patients with advanced cancer may allow for improved end of life care. Although the data suggests oncologists struggle with accurately predicting patients' prognosis, there is a dearth of literature on medical residents' abilities to prognosticate. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - January 25, 2020 Category: Palliative Care Authors: Maria Hansberry, Seema Limaye, Anne Day, Virginia Bove, Alexi Vahlkamp, Ariel Laudermith, Amanda Bowers, Cheryl Czerlanis Source Type: research