Abstract:
:As part of a Veterans Health Administration (VA) commitment to improve end-of-life care the VA Greater Los Angeles Healthcare System (GLA) implemented Pathways of Caring, a 3-year demonstration project targeting patients with inoperable lung cancer and advanced heart failure and chronic lung disease. The program utilized case-finding for early identification of poor-prognosis patients, interdisciplinary palliative assessment, and intensive nurse care coordination to optimize symptom management, continuity and coordination of services across providers and care settings, and support for families. Program evaluation used patient and family surveys as well as reviews of medical records and administrative databases to assess processes and outcomes of care. Despite significant programmatic challenges including organizational instability and evaluation design issues, the program achieved measurable success including high rates of advance care planning, hospice enrollment, and death at home, and low end-of-life hospital and Intensive Care Unit (ICU) use. As a result of its success, the program will be expanded and its care model extended institution-wide.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Rosenfeld K,Rasmussen Jdoi
10.1089/109662103322515428subject
Has Abstractpub_date
2003-10-01 00:00:00pages
831-9issue
5eissn
1096-6218issn
1557-7740journal_volume
6pub_type
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更新日期:2019-11-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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