Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2023
Operationalizing Depression Screening in Ambulatory Palliative Care: A Quality Improvement Project.
Depression is common in the palliative care setting and impacts outcomes. Operationalized screening is unusual in palliative care. ⋯ Operationalized depression screening is feasible in ambulatory palliative care workflow, though optimization through having screening be completed prior to clinician visit might improve uptake.
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J Pain Symptom Manage · Jan 2023
Communication training and code status conversation patterns reported by emergency clinicians.
During acute health decompensations for seriously ill patients, emergency clinicians often determine the intensity end-of-life care. Little is known about how emergency clinicians conduct these conversations, especially among those who have received serious illness communication training. ⋯ Most emergency clinicians reported asking about procedure-based questions, and some asked about patient's value-based questions. Clinicians with recent serious illness communication training may ask more about some values and priorities.
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J Pain Symptom Manage · Jan 2023
Quality of Telehealth-Delivered Inpatient Palliative Care During the Early COVID-19 Pandemic.
Consequent to increasing COVID-19 infection rates, the Palliative Care (PC) service at a large New England hospital shifted from in-person to telehealth-delivered PC (TPC). ⋯ The PC service provided high-quality inpatient PC using TPC despite significant strain during the early COVID-19 pandemic. Developing and testing strategies to promote comprehensive symptom control using TPC remains a priority to adjust to potential unmet PC needs.
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Early integration of palliative care (PC) improves outcomes for patients with cancer and heart failure. Data on the role of PC in complex general medicine patients is scant. ⋯ Our initiative identified hospitalized primary care patients with high-mortality risk, improved gaps in ACP, and was feasible to implement.