Articles: palliative-care.
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J Pain Symptom Manage · May 2021
Workforce Planning for Community-based Palliative Care Specialist Teams using Operations Research.
Many countries have aging populations. Thus, the need for palliative care will increase. However, the methods to estimate optimal staffing for specialist palliative care teams are rudimentary as yet. ⋯ Historical, current, and projected data can be used with operations research to forecast staffing levels for specialist palliative care teams under various scenarios. The forecast can be updated as new data emerge, applied to other populations, and used to test alternative delivery models.
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Am J Hosp Palliat Care · May 2021
"If You Call Them, They Will Come": A Telephone Call Reminder to Decrease the No-Show Rate in an Outpatient Palliative Medicine Clinic.
A high outpatient clinic no-show rate affects clinical outcomes, increases healthcare costs, and reduces both access to care and provider productivity. In an effort to reduce the no-show rate at a busy palliative medicine outpatient clinic, a quality improvement project was launched consisting of a telephone call made by clinic staff prior to appointments. The study aimed to determine the effect of this intervention on the no-show rate, and assess the financial impact of a decreased no-show rate. ⋯ A telephone call reminder to patients 24 hours prior to their appointment decreased the no-show rate in an outpatient palliative medicine clinic. Avoiding unfulfilled visits resulted in substantial opportunity costs.
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Medication deprescribing in palliative care settings has been insufficiently studied. ⋯ The findings from this pilot study revealed that a collaborative, pharmacist-led, collaborative medication deprescribing program initiative was associated with a 79% success in ≥50% medication reduction. More frequent patient encounters had higher odds of success. Future studies, utilizing a control group, should focus on determining the effectiveness of the program and the impact on quality of life.
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J Pain Symptom Manage · May 2021
Observational StudySelection Bias in Observational Studies of Palliative Care: Lessons Learned.
Palliative care (PC) programs are typically evaluated using observational data, raising concerns about selection bias. ⋯ This case study demonstrates that selection of comparison groups impacts the magnitude of measured and unmeasured confounding, which may change effect estimates. The substantial impact of confounding on effect estimates in this study raises concerns about the evaluation of novel serious illness care models in the absence of randomization. We present key lessons learned for improving future evaluations of PC using observational study designs.
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To ascertain whether internists know what limitation of therapeutic effort (LTE) means and whether training in palliative care affects this understanding. ⋯ Only 1 of every 4 internists knew the proper definition of LTE, with no association with level of training in palliative care.