Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2023
From Hospital to Home: Referrals to pediatric hospice and home-based palliative care.
Hospital-based pediatric palliative care (PPC) may help optimize referrals to community-based hospice and home-based palliative care (HBPC) for children with serious illness, yet little is known about their referral practices. ⋯ Despite demographic eligibility, a minority of patients seen by a hospital-based PPC team received referrals for hospice or HBPC. Children discharged from an ICU and those with neurologic conditions may be at higher risk of missing referrals best aligned with their needs. Future research should identify and address causes of referral misalignment. Advocacy for programs adaptable to patients' changing needs may also be needed.
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J Pain Symptom Manage · Jun 2023
Comment Letter ReviewResponse to Advance Care Planning in Serious Illness: A Narrative Review.
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J Pain Symptom Manage · Jun 2023
The Team-based Serious Illness Care Program, a qualitative evaluation of implementation and teaming.
Earlier and more frequent serious illness conversations with patients allow clinical teams to better align care with patients' goals and values. Nonphysician clinicians often have unique perspectives and understanding of patients' wishes and are thus well-positioned to support conversations with seriously ill patients. The Team-based Serious Illness Care Program (SICP) at Stanford aimed to involve all care team members to support and conduct serious illness conversations with patients and their caregivers and families. ⋯ Team-based serious illness communication is viable and valuable, with a range of successful workflow and leadership approaches.
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J Pain Symptom Manage · Jun 2023
Patterns of pediatric palliative and end-of-life care in neonatal intensive care patients in the Southern U.S.
Despite high rates of mortality among infants in the Southern U.S., little is known about the timing of pediatric palliative care (PPC), the intensity of end-of-life care, and whether there are differences among sociodemographic characteristics. ⋯ Overall, PPC consultation occurred late in NICU hospitalizations, infants received high-intensity medical interventions in the last 48 hours of life, and there are disparities in intensity of treatment interventions at end of life. Further research is needed to explore if these patterns of care reflect parent preferences and goal concordance.