• J Pain Symptom Manage · Oct 2017

    Development of a Protocol for Successful Palliative Care Consultation in Population of Patients Receiving Mechanical Circulatory Support.

    • Shilpee Sinha, Carey Belcher, Alexia Torke, Joycelyn Howard, Marco Caccamo, James E Slaven, and Irmina Gradus-Pizlo.
    • Indiana University (IU) School of Medicine, Indianapolis, Indiana; IU Health Physicians, Indianapolis, Indiana. Electronic address: ssinha@iuhealth.org.
    • J Pain Symptom Manage. 2017 Oct 1; 54 (4): 583-588.

    BackgroundIn 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population.MeasuresThe goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) before MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation.InterventionA protocol was developed to conduct interdisciplinary PC consultations for the MCS population.OutcomesThe percentage of PC consults placed before MCS implantation increased from 11 (17.2%) before protocol to 56 (96.6%) after protocol (P < 0.0001) and documented SDM increased from 26 (40.6%) before protocol to 57 (98.3%) after protocol (P < 0.0001).ConclusionsClose PC/cardiology collaboration can substantially improve ACP discussions and SDM documentation in the MCS population. This multidisciplinary protocol facilitates successful PC consultations.Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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