Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2020
Engaging Hospices in Quality Measurement and Improvement: Early Experiences of a Large Integrated Healthcare System.
The quality of hospice care remains highly variable in the U. S. Patients, providers, and health care systems lack a comprehensive method of measuring the quality of care provided by an individual hospice. ⋯ For hospices scoring above the 15th percentile (n = 19), scores ranged from 10.0 to 19.5 (median 14). The hospice RFI process is one health care system's attempt to evaluate hospice quality. Further research will determine whether the scoring system proves to be a sensitive, specific, and reproducible measure of hospice quality, and whether the collaborative can foster quality improvement over time.
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J Pain Symptom Manage · Oct 2020
Creating a Resilient Research Program - Lessons Learned from a Palliative Care Research Lab.
Conducting palliative care research can be personally and professionally challenging. Although limitations in funding and training opportunities are well described, a less recognized barrier to successful palliative care research is creating a sustainable and resilient team. In this special report, we describe the experience and lessons learned in a single palliative care research laboratory. ⋯ Finally, we changed our leadership approach to foster psychological safety and shared mission. Since then, no team member has left, and the program has thrived. As the demand for rigorous palliative care research grows, we hope this report will provide perspective and ideas to other established and emerging palliative care research programs.
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J Pain Symptom Manage · Oct 2020
Terminally ill cancer patients' emotional preparedness for death is distinct from their accurate prognostic awareness.
Emotional preparedness for death (hereafter called death preparedness) and prognostic awareness (PA), a distinct but related concept, each contributes to patients' practical, psychological, and interpersonal preparations for death. However, the distinction between these two concepts has never been investigated. ⋯ The distinction between death preparedness and accurate PA was supported by their poor agreement, lack of reciprocal associations, and two different sets of predictors. Health care professionals should not only cultivate cancer patients' accurate PA but also facilitate emotional preparation for death to achieve a good death and improve end-of-life care quality.