Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2023
Lessons Learned from an Embedded Palliative Care Model in the Medical Intensive Care Unit.
To describe a physician (MD) and registered nurse (RN) led palliative care consultation team embedded in the medical intensive care unit (MICU). To compare patterns of palliative care consultation, and rates of goals of care documentation and in-ICU mortality before and after the implementation of the embedded team. ⋯ After embedding a palliative care MD/RN team into the MICU, patients received earlier palliative care consultation, were more likely to have medical decision-maker and goals of care documented, and less likely to die in the hospital. Future work will examine how to adapt this model to other ICUs to improve palliative care access for critically ill patients broadly.
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J Pain Symptom Manage · Apr 2023
Creating a dedicated palliative care team for ICU Spanish speaking patients in response to COVID-19.
The Latinx population faced higher rates of infection and severe illness during the COVID-19 pandemic, resulting in an increased need for palliative care services. ⋯ The creation of a focused clinical program targeting a historically marginalized population offered opportunity for early palliative care intervention in clinical care for Spanish-speaking patients. This underscores the need for Spanish-language concordant palliative care to improve serious illness care, and end-of-life care, by providing continuity of care, spiritual care, and ICU team support.
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J Pain Symptom Manage · Apr 2023
A Call for the Creation of LGBTQ+ Competencies for Hospice and Palliative Medicine (HPM) Fellowship Programs.
LGBTQ+ people and their families have unique needs, concerns, and issues when navigating serious illness. ⋯ Learning to provide culturally competent care is essential for all HPM providers. Our group recommends specific clinical training competencies with plans to pilot them in upcoming academic years. Creating curricular recommendations will help guide fellowship programs education in the care of LGBTQ+ patients with serious illness.
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J Pain Symptom Manage · Apr 2023
Just-in-Time Decision Making: Preliminary Findings of a Goals of Care Rapid Response Team.
The COVID-19 pandemic placed the issue of resource utilization front and center. Our comprehensive cancer center developed a Goals of Care Rapid Response Team (GOC RRT) to optimize resource utilization balanced with goal-concordant patient care. ⋯ GOC RRT consultations were feasible and associated with care limitation. Adherence to core team participation was fair.