Download or read book Palliative Care Initiative Advance Care Planning Quality Improvement Pilot written by Wilma Carrier and published by . This book was released on 2017 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background : A long term care facility (LTCF) was instituting a creative care model with an emphasis on palliative care. A lack of advance care planning including completion of advance directives was an identified barrier for the new care model. Code status was considered an advance directive prior to the pilot. -- Method : A mixed method interventional design was used. The social service staff and chaplain were trained in Caring Conversations (Center for Practical Bioethics, n.d.) as a tool to address end of life care with LTCF residents. The number of completed advanced directives were assessed three months pre and post-training via retrospective chart review. The chaplain’s and social services staffs’ knowledge of advance care planning pre and post Caring Conversations educational sessions was assessed via informal surveys. -- Results : This project sought to determine if the initiation of advanced care planning conversations increased the number of completed advance directives for individuals in a LTCF setting after the chaplain and social service staff participated in the Caring Conversations educational intervention. Retrospective chart reviews were conducted on 125 residents, over 50% of whom were females over the age of 80 who had been living in the facility 3 or more years. There was a significant increase (30%, p

Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Download or read book Deciding to Engage in Advance Care Planning written by Karen Joy Vander Laan and published by . This book was released on 2007 with total page 462 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Models and Strategies to Integrate Palliative Care Principles into Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2018-02-28 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: Palliative care is the interdisciplinary specialty focused on improving quality of life for people with serious illness and their families. This interdisciplinary care is provided by doctors, nurses, social workers, chaplains and others who work together with the patient's other doctors to provide an extra layer of support. Such care is appropriate for people at any age and at any stage in a serious illness, and can be provided together with curative treatment to address clinical, emotional, psychosocial and spiritual concerns of the patient and their family. To better understand how the principles of palliative care can be integrated into the overall provision of care and services to those facing serious illness, the Roundtable on Quality Care for People with Serious Illness held a public workshop in April 2017. This publication summarizes the presentations and discussions from the workshop.

Download or read book Advance Care Planning in End of Life Care written by Keri Thomas and published by Oxford University Press. This book was released on 2018 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: ACP is an essential part of end of life care with patients improving their chances of 'a good death' by creating plans with their families and carers. This new edition gives a comprehensive overview of ACP, explores a wide range of issues and practicalities in providing end of life care, and offers a worldwide perspective.

Download or read book The Effectiveness of a Computer based Decision Aid in Increasing Nursing Knowledge of Advance Care Planning written by Raysha Patterson and published by . This book was released on 2013 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Barriers exist to early implementation of quality palliative care, including lack of education for clinicians. A project was developed to evaluate the effectiveness of a computer-based program on advance care planning. A pilot study was conducted with a convenience sample of six nurses at a community hospital. Participants completed an advance care planning knowledge survey pre- and post-exposure to the computer program. The mean score of the pre- and post-intervention survey increased from 85.3% to 90.2%. Nurses demonstrated increased comfort in discussing end-of-life decisions. All participants would recommend the program to their patients. The computer-based decision aid is a tool that can increase advance care planning knowledge for nurses. Further research is needed to identify effective nursing educational tools for palliative and end-of-life care.

Download or read book The Common Sense Guide to Improving Palliative Care written by Joanne Lynn M.D. and published by Oxford University Press. This book was released on 2007-02-08 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Improving care for the patients who are in the last phase of their lives has been a field that most health care providers have struggled with during last few years. Having worked with hundreds of providers throughout the country, these experienced authors know what providers need when it comes to implementing a quality improvement project. This guide will provide user-friendly, step-by-step instructions on how to implement a quality improvement project in the full range of care settings. The instructions will be brought to life with specific examples from actual successful projects and key information on the best practices in the industry. Readers will also be pointed to resources available online and elsewhere, with information on how to access them. The guide will be written in an informal, maximally helpful style, with checklists, tables, and boxed information. Answering 80% of the questions in less than half the space, The Common Sense Guide is the perfect portable companion to Dr. Lynn's desk reference, Improving Care for the End of Life. The book will be of great interest to all health care professionals involved in the care of those with serious chronic illness -- doctors, nurses, social workers, chaplains, clinic administrators, quality improvement experts, and so forth.

Download or read book Implementing Quality Measures for Accountability in Community Based Care for People with Serious Illness written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-11 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: Millions of Americans of all ages face the challenge of living with serious illnesses such as advanced cancer, heart, or lung disease. Many people with serious illness are increasingly cared for in community settings. While the number of community-based programs to provide care for those with serious illness has grown significantly, the quality of care provided is not consistent across geographic locations or care settings. Care for the serious illness population often features gaps in coordination across sites of care and poor patient and family perceptions as to the quality of care provided. In an effort to better understand and facilitate discussions about the challenges and opportunities related to identifying and implementing quality measures for accountability purposes in community-based serious illness care, the National Academies of Sciences, Engineering, and Medicine held a public workshop on April 17, 2018, in Washington, DC. Workshop participants explored the current state of quality measurement for people with serious illness, their families, and caregivers, with the aim of identifying next steps toward effectively implementing measures to drive improvement in the quality of community-based care for those facing serious illness. This publication summarizes the presentations and discussions from the workshop.

Download or read book Advanced Practice Palliative Nursing written by Constance Dahlin and published by Oxford University Press. This book was released on 2016-02-25 with total page 649 pages. Available in PDF, EPUB and Kindle. Book excerpt: Advanced Practice Palliative Nursing is the first text devoted to advanced practice nursing care of the seriously ill and dying. This comprehensive work addresses all aspects of palliative care including physical, psychological, social, and spiritual needs. Chapters include: symptoms common in serious illness, pediatric palliative care, spiritual and existential issues, issues around the role and function of the advanced practice nurse (APN), reimbursement, and nursing leadership on palliative care teams. Each chapter contains case examples and a strong evidence base to support the highest quality of care. The text is written by leaders in the field and includes authors who have pioneered the role of the advanced practice nurse in palliative care. This volume offers advanced practice content and practical resources for clinical practice across all settings of care and encompassing all ages, from pediatrics to geriatrics.

Download or read book Approaching Death written by Committee on Care at the End of Life and published by National Academies Press. This book was released on 1997-10-30 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Download or read book Hospital Based Palliative Medicine written by Steven Z. Pantilat and published by John Wiley & Sons. This book was released on 2015-01-27 with total page 276 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first comprehensive, clinically focused guide to help hospitalists and other hospital-based clinicians provide quality palliative care in the inpatient setting. Written for practicing clinicians by a team of experts in the field of palliative care and hospital care, Hospital-Based Palliative Medicine: A Practical, Evidence-Based Approach offers: Comprehensive content over three domains of inpatient palliative care: symptom management, communication and decision making, and practical skills, Detailed information on assessment and management of symptoms commonly experienced by seriously ill patients, Advise on the use of specific communication techniques to address sensitive topics such as prognosis, goals of care, code status, advance care planning, and family meetings in a patient- and family-centered manner, Targeted content for specific scenarios, including palliative care emergencies, care at the end of life, and an overview of post-hospital palliative care options, Self-care strategies for resilience and clinician wellness which can be used to help maintain an empathic, engaged, workforce and high quality patient care, A consistent chapter format with highlighted clinical pearls and pitfalls, ensuring the material is easily accessible to the busy hospitalist and associated hospital staff. This title will be of use to all hospital clinicians who care for seriously ill patients and their families. Specialist-trained palliative care clinicians will also find this title useful by outlining a framework for the delivery of palliative care by the patient’s front-line hospital providers. Also available in the in the Hospital-Based Medicine: Current Concepts series: Inpatient Anticoagulation Margaret C. Fang, Editor, 2011 Hospital Images: A Clinical Atlas Paul B. Aronowitz, Editor, 2012 Becoming a Consummate Clinician: What Every Student, House Officer, and Hospital Practitioner Needs to Know Ary L. Goldberger and Zachary D. Goldberger, Editors, 2012 Perioperative Medicine: Medical Consultation and Co-Management Amir K. Jaffer and Paul J. Grant, Editors, 2012 Clinical Care Conundrums: Challenging Diagnoses in Hospital Medicine James C. Pile, Thomas E. Baudendistel, and Brian J. Harte, Editors, 2013 Inpatient Cardiovascular Medicine Brahmajee K. Nallamothu and Timir S. Baman, Editors 2013

Download or read book Palliative Care in Oncology written by Bernd Alt-Epping and published by Springer. This book was released on 2015-03-26 with total page 302 pages. Available in PDF, EPUB and Kindle. Book excerpt: Palliative care provides comprehensive support for severely affected patients with any life-limiting or life-threatening diagnosis. To do this effectively, it requires a disease-specific approach as the patients’ needs and clinical context will vary depending on the underlying diagnosis. Experts in the field of palliative care and oncology describe in detail the needs of patients with advanced cancer in comparison to those with non-cancer disease and also identify the requirements of patients with different cancer entities. Basic principles of symptom control are explained, with careful attention to therapy for pain associated with either the cancer or its treatment and to symptom-guided antineoplastic therapy. Complex therapeutic strategies for palliative cancer patients are highlighted that involve both cancer- and symptom-directed options and address a range of therapeutic aims. Issues relating to drug use in palliative cancer care are fully explored, and a separate section is devoted to care in the final phase. A range of organizational and policy issues are also discussed, and the book concludes by considering likely future developments in palliative care for cancer patients. Palliative Care in Oncology will be of particular interest to palliative care physicians who are interested in broadening the scope of their disease-specific knowledge, as well as to oncologists who wish to learn more about modern palliative care concepts relevant to their day-to-day work with cancer patients.

Download or read book Heart Failure and Palliative Care written by Miriam Johnson and published by Radcliffe Publishing. This book was released on 2006 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: Heart failure is a very common terminal condition but few patients receive proper palliative care. This text is full of practical, evidence based advice, and encourages a multidisciplinary team based approrach.

Download or read book Meeting the Needs of Older Adults with Serious Illness written by Amy S. Kelley and published by Humana. This book was released on 2014-09-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform provides an introduction to the principles of palliative care; describes current models of delivering palliative care across care settings, and examines opportunities in the setting of healthcare policy reform for palliative care to improve outcomes for patients, families and healthcare institutions. The United States is currently facing a crisis in health care marked by unsustainable spending and quality that is poor relative to international benchmarks. Yet this is also a critical time of opportunity. Because of its focus on quality of care, the Affordable Care Act is poised to expand access to palliative care services for the sickest, most vulnerable, and therefore most costly, 5% of patients- a small group who nonetheless drive about 50% of all healthcare spending. Palliative care is specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis or stage of illness. The goal is to improve quality of life for both the patient and the family. Research has demonstrated palliative care’s positive impact on health care value. Patients (and family caregivers) receiving palliative care experience improved quality of life, better symptom management, lower rates of depression and anxiety, and improved survival. Because patient and family needs are met, crises are prevented, thereby directly reducing need for emergency department and hospital use and their associated costs. An epiphenomenon of better quality of care, the lower costs associated with palliative care have been observed in multiple studies. Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, a roadmap for effective policy and program design, brings together expert clinicians, researchers and policy leaders, who tackle key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value.

Download or read book Program Evaluation of an Outpatient Palliative Care Model written by Molly Jackson and published by . This book was released on 2015 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Americans are living longer than ever, and with a greater number of comorbid conditions. In 2012 there were approximately 90 million Americans living with serious illness and this number is expected to double in the next 25 years (http://www.dartmouthatlas.org/data/topic/topic.aspx?cat=1). Palliative care consulting services have been initiated in many urban hospital settings with evidence of benefits for patients in terms of symptom management, and goal-directed care (Meier, Isaacs, & Hughes 2010). Additionally, outpatient programs providing palliative care to patients diagnosed with cancer have been described in the literature (Jackson, 2013; Teno, Gonzalo, Bynum, Leland, Miller, ...& Morrison, 2013; Zimmerman, Swami, Krzyanowska, Hannon, Leighl, Oza, ... & Lo, 2014). Little is known, however, about the impact of providing palliative care in home settings to clients with non-cancer diagnoses. The purpose of this study is to describe an evaluation of a home-based palliative care pilot program developed as a partnership between administrators of an adult-living community and a palliative-care consult team. The evaluation covered a period of one year from December 2012 to December 2013. The program evaluation addresses the following questions: What was the impact of early palliative care related to unplanned hospitalizations and emergency department visits as compared to patients receiving standard palliative care? What was the impact of early palliative care relating to advance care planning as compared with patients receiving standard palliative care? What was the impact of early palliative care relating to the number of advanced practice nursing visits and social work visits as compared to patients receiving standard palliative care? Was there a difference in client satisfaction between the two groups? The Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health model was used to evaluate the pilot initiative (Yarbrough, Shulha, Hopson, & Caruthers, 2011).Twenty-nine clients in the pilot group were matched with a comparison group of 29 clients receiving standard palliative care. Quantitative data were collected by means of electronic medical record review and survey analysis. Group differences were assessed using chi-square and Mann-Whitney tests. Median emergency department visits were 1.00 in the pilot group compared to 0.00 in the standard care group. There were no statistical differences in hospitalizations or in rates of completed advance directives. The pilot group received significantly more social work visits (Mdn=5) than the standard palliative care group (Mdn=1). Advanced practice nurse visits between groups were not significantly different with a median number of three visits each. Limitations of the program evaluation include a small pilot sample size (N=29), inability to estimate program costs, possible comparison group selection bias, and a lack of generalizability. More study is needed to see whether this model is effective and can be applicable to other settings.

Download or read book Advance Care Planning in End of Life Care written by Keri Thomas and published by Oxford University Press, USA. This book was released on 2011 with total page 325 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is the first UK-based guide to Advance Care Planning, and provides practical advice on how this can be implemented by all professionals involved in end of life care, including GPs and specialists outside palliative care who are increasingly treating patients at the end of life.

Download or read book Advance Planning for Quality Care at End of Life written by and published by . This book was released on 2013 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: