Abstract：
BACKGROUND:There is a growing movement to increase palliative care consults from the emergency department (ED) to reduce healthcare costs and improve quality of life. The surprise question is a screening tool that emergency medicine physicians may be able to use towards achieving this goal. OBJECTIVE:The objectives of this study were to increase awareness of hospice and palliative care medicine (HPM) among emergency medicine (EM) providers and to evaluate whether this heightened awareness increased palliative care consults among participating emergency medicine providers. METHODS:We conducted an anonymous convenience sample survey and two educational interventions about HPM including the surprise question among emergency medicine resident and attending physicians at a large urban public academic quaternary care center from July to November 2018. A report of palliative care consults ordered between August 1, 2017 and January 1, 2019 was generated from the electronic health records used by the hospital. The number of palliative care consults made before and after the educational intervention was compared. RESULTS:After the first educational intervention centered on the surprise question, palliative care consults from the ED increased from an average of 2.25 per month (range 0 to 8, SD: 2.38) to 12.67 per month (range 9 to 19, SD: 4.01, p < .001). CONCLUSION:Educating EM physicians about the surprise question can increase the number of palliative care consults from the ED, thereby potentially improving patient care and decreasing costs by avoiding unwanted healthcare interventions.
journal_name
J Palliat Carejournal_title
Journal of palliative careauthors
Zeng H,Eugene P,Supino Mdoi
10.1177/0825859719866698subject
Has Abstractpub_date
2020-10-01 00:00:00pages
221-225issue
4eissn
0825-8597issn
2369-5293journal_volume
35pub_type
杂志文章abstract：UNLABELLED:In Poland, medical curricula cover palliative care for adults, not for children. This paper evaluates feedback of students who participated in a pilot pediatric palliative care education program. METHOD:An anonymous questionnaire was designed for the students; they were asked to assess each aspect of the pr...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:The anniversary of a death is perceived as a difficult time by the majority of closely bereaved relatives and friends. Bereavement anniversary cards are supportive and useful in the context of wider follow-up. This study identified no strong predictors to indicate those for whom such a card would be inappropriate. Sev...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1995-10-01 00:00:00
abstract：:Morphine and hydromorphone infusions of 6 or more (average 25.75) days in duration were used with increasing frequency (up to 7%) by our oncology inpatients. Eighty-six percent of the 135 inpatients we reviewed realized good pain control with dose rates up to 700 morphine-equivalent (ME) mg/h. Local toxicity occurred ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1990-07-01 00:00:00
abstract：:Informal hospice caregivers play a key role in managing patients' pain at home, but lack of adherence to doctor-prescribed analgesic regimens and medication errors are significant barriers to truly effective pain management. A digital pain diary may improve caregiver management of pain at home; however, most digital p...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859717722466
更新日期：2017-04-01 00:00:00
abstract：:Current definitions of "symptom burden" are largely derived from clinicians, and there are many variations in the way the term is used, defined, and operationalized. The aim of this study was to explore patient perceptions of symptom burden in the context of advanced and incurable disease. A group of 58 cancer patient...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2012-07-01 00:00:00
abstract：:Families of patients are well poised to comment on the end-of-life (EOL) care received by those patients and can provide feedback to care providers and decision makers. To better understand family-member evaluations of the quality of in-patient EOL care, this study draws on qualitative interview data (n = 24) to ident...
journal_title：Journal of palliative care
pub_type： 杂志文章,多中心研究
doi：
更新日期：2011-01-01 00:00:00
abstract：:Doctor-patient communication is a quintessential part of medical care. Yet, several factors challenge its effectiveness. The author, a third year Pediatrics resident, explores the ways medical education creates distance between doctors' and patients' ability to achieve mutual understanding in the clinical setting and ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859718795438
更新日期：2019-01-01 00:00:00
abstract：:This paper presents an overview of a qualitative study of six recently discharged hospice patients, who had experienced at least two episodes of inpatient palliative care and who were interviewed about their experience of care. The resulting data formed a representation--the Circle of Care--with a central theme being ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2001-04-01 00:00:00
abstract：:Inpatient palliative care consultation has been demonstrated to improve quality of life as well as decrease hospital readmissions, intensive care unit transfers, and hospital costs for people with a life limiting illness. The clinical teaching units (CTUs) at London Health Sciences Centre (LHSC) routinely admit patien...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859718781363
更新日期：2018-10-01 00:00:00
abstract：:This multi-centre study of adjuvant "burst" ketamine in palliative care in-patients documents its effectiveness, duration of pain relief, and adverse effects (AE) profile. Patients received a three-to-five day continuous subcutaneous infusion (CSCI) of ketamine escalated from 100 to 300 to 500 mg/24 hours if required....
journal_title：Journal of palliative care
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：2010-10-01 00:00:00
abstract：:The emphasis of palliative care has been to support both patients and their family caregivers, and to maintain the caregivers' involvement through the patient's illness and death. This study challenges the assumption that people with amyotrophic lateral sclerosis (ALS) and those who care for them at home have a simila...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2001-01-01 00:00:00
abstract：AIM:By examining clinical parameters associated with survival time and analyzing patients' survival times using prognostic scores, this study aimed to provide helpful information related to the treatment of terminal cancer patients. METHODS:We retrospectively reviewed the medical records of 415 inpatients who died in ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2014-04-01 00:00:00
abstract：:This retrospective study compared 100 consecutive non-cancer (NC) patients referred to a palliative care consult team (PCT) in a Swiss university hospital to 506 cancer (C) patients referred during the same period. The frequencies of reported symptoms were similar in both groups. The main reasons for referral in the N...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Advance care planning is not well implemented in Belgian hospital practice. In order to obtain successful implementation, implementation theory states that the adopters should be involved in the implementation process. This information can serve as a basis for creating better implementation strategies. AIM:...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859720938583
更新日期：2020-10-01 00:00:00
abstract：:In 2006, the Indian Health Service (IHS) and the National Cancer Institute (NCI) collaborated to develop an interdisciplinary palliative training program for health professionals in the Indian health system. Their goal was to improve clinician knowledge and skills in palliative care, to train future trainers, and to i...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：BACKGROUND:Despite the central role of hospice in end-of-life care, little is known about the proportion of terminally ill patients referred for hospice and the physician factors associated with hospice referral. METHODS:Cross-sectional data from a self-administered survey of 231 physicians were used to estimate the p...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The use of chemotherapy at the end of life in advanced cancer patients has increased and end of life care has become increasingly aggressive. The aim of this study is to evaluate patients receiving chemotherapy in the last 3 months of life and the aggressiveness of end-of-life support of these...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859720946505
更新日期：2020-08-06 00:00:00
abstract：:Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at t...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2012-04-01 00:00:00
abstract：AIM:The aim of this study was to evaluate the utility of the Edmonton Symptom Assessment System (ESAS-r) Scale on a tertiary palliative care unit. METHOD:There were 92 admitted patients who participated in the study; the scale was administered to those able to participate on day 1 (n = 35, 38 percent), on day 4 (n = 2...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/082585971503100107
更新日期：2015-01-01 00:00:00
abstract：PURPOSE:To evaluate the perception of attending physicians, medical residents, and undergraduate medical students about death and dying, the end of life (EoL), and palliative care (PC) during training and clinical practice, highlighting knowledge gaps, and the changes needed in medical school curricula. METHOD:Cross-s...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859720923435
更新日期：2020-05-10 00:00:00
abstract：:There has been little research into pressure ulcer prevention and treatment in hospices. In this study, interviews with hospice directors of clinical services and direct-care nurses were analyzed using qualitative methods. Several general themes were found. Both pressure ulcer prevention and treatment can be painful t...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2003-04-01 00:00:00
abstract：BACKGROUND:One challenge for those who manage amyotrophic lateral sclerosis (ALS) is to understand patients' needs. AIM:The aim of this study was to examine the needs of Singapore ALS patients from their perspective as well as that of their caregivers and healthcare professionals in order to develop a template for bet...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/082585971503100304
更新日期：2015-01-01 00:00:00
abstract：:Historically, health and social care professionals have described their lack of competence and confidence in many aspects of palliative care, and have recognized the need for increased educational opportunities, where new skills can be acquired and existing knowledge consolidated. Redressing these omissions has led to...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
abstract：BACKGROUND:The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by pa...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859718769099
更新日期：2018-07-01 00:00:00
abstract：:This study measures the proportion of cancer patients in Ontario, Canada, with intensive care unit (ICU) admissions, emergency room (ER) visits, or chemotherapy in the last two weeks of life. We used the Ontario Cancer Registry to identify a cohort of cancer patients who died in 2001. These cases were then linked to a...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2006-04-01 00:00:00
abstract：OBJECTIVE:Palliative, end-of-life care (PEOLC) providers are poorly resourced in addressing the needs of patients with mental health challenges, and the dying experiences of this cohort-particularly those with a comorbid, chronic and persistent mental illness (CPMI)-are poorly documented. We sought to explore the exper...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：10.1177/0825859720951360
更新日期：2020-08-18 00:00:00
abstract：:The conduct of psychosocial research with palliative care patients or staff presents a major investigative challenge. The fragility of patients and their physical or cognitive limitations severely curtail the types of studies that are possible and the research methods that can be applied. A major limitation is that ra...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1989-12-01 00:00:00
abstract：:Caregivers are often overwhelmed by the strain of terminal caregiving. We wished to better understand the needs of terminal caregivers and to supply a basis for tailoring interventions to them during caregiving and early bereavement. This report provides a profile of 124 bereaved caregivers interviewed within three mo...
journal_title：Journal of palliative care
pub_type： 杂志文章,多中心研究
doi：
更新日期：1999-04-01 00:00:00
abstract：:In Spain, there is a general tendency to conceal the prognosis from a terminally ill patient. We conducted grounded-theory-based, phenomenological, qualitative research on this using a final sample of 42 in-depth interviews with doctors and nurses from different fields. We found that most health professionals believe ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：2009-10-01 00:00:00
abstract：:Daily care involving proximity with a malodorous patient in the terminal stage of cancer has often proved difficult for the caregiver. Whatever the cause of the primary cancer, three sources of noxious odor can exist or coexist: necrosis, superinfection, and perspiration and/or discharge. The proposed treatment calls ...
journal_title：Journal of palliative care
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
