No Patient Left Behind: Universal Screening for Palliative Care Needs in an Integrated Health System

2.50
Hdl Handle:
http://hdl.handle.net/10755/157117
Category:
Abstract
Type:
Presentation
Title:
No Patient Left Behind: Universal Screening for Palliative Care Needs in an Integrated Health System
Author(s):
Hicks, Mary; Distefano, Elizabeth
Author Details:
Mary Hicks, Saint John Hospital and Medical Center, Detroit, Michigan, USA, email: mary.hicks@stjohn.org; Elizabeth Distefano
Abstract:
PURPOSE: The purpose of the study was to evaluate the effectiveness of a "palliative care screening tool" (PCST) by identifying: 1) percentage of patients who had any palliative care needs; 2) palliative care team referrals resulting from the PCST; 3) common criteria leading to (PCT) referral; 4) common palliative care needs for patients not referred to the team; and 5) burden reported by users of the tool. BACKGROUND: As part of a larger project to increase attention to palliative care needs, including needs for spiritual care, throughout a hospital system, we developed and implemented a PCST that identified patients for palliative care team (PCT) consultation and patients with less urgent palliative care needs. METHODS: The PCST was pilot tested in the MICU, two medical/surgical units and one oncology unit; case managers and social workers completed the tool for each patient. Data were analyzed for the MICU and non-MICU separately. When a patient was found to meet the criteria, the patient's attending physician was contacted to give them the information and suggest a palliative care consult. Quantitative and qualitative data were collected to evaluate the implementation of the tool including: number of PCSTs completed, disposition of the PCST, palliative care consults resulting from the PCST, reasons orders for palliative care were not written for patients meeting the criteria, and staff feedback. RESULTS: The tool successfully identified patients in need of PCT consultation; 46% of MICU and 12% of non-MICU patients met criteria for PCT consultation. PCT referrals from the MICU increased 4 fold in one year. Qualitative data showed that the tool was well-received in the MICU but was a burden to use on other units, primarily because of its length, complexity, and relatively small number of patients identified. The PCST data revealed ten primary patient criteria associated with PCT referral or "triggers". CONCLUSIONS: Use of a longer screening tool in the MICU was effective in identifying palliative care needs and increasing referrals to the PCT. Incorporating screening criteria or "triggers" into existing assessment tools for nursing, case management, social work and pastoral care services increased attention to palliative care needs and increased referrals to the PCT.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleNo Patient Left Behind: Universal Screening for Palliative Care Needs in an Integrated Health Systemen_GB
dc.contributor.authorHicks, Maryen_GB
dc.contributor.authorDistefano, Elizabethen_GB
dc.author.detailsMary Hicks, Saint John Hospital and Medical Center, Detroit, Michigan, USA, email: mary.hicks@stjohn.org; Elizabeth Distefanoen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157117-
dc.description.abstractPURPOSE: The purpose of the study was to evaluate the effectiveness of a "palliative care screening tool" (PCST) by identifying: 1) percentage of patients who had any palliative care needs; 2) palliative care team referrals resulting from the PCST; 3) common criteria leading to (PCT) referral; 4) common palliative care needs for patients not referred to the team; and 5) burden reported by users of the tool. BACKGROUND: As part of a larger project to increase attention to palliative care needs, including needs for spiritual care, throughout a hospital system, we developed and implemented a PCST that identified patients for palliative care team (PCT) consultation and patients with less urgent palliative care needs. METHODS: The PCST was pilot tested in the MICU, two medical/surgical units and one oncology unit; case managers and social workers completed the tool for each patient. Data were analyzed for the MICU and non-MICU separately. When a patient was found to meet the criteria, the patient's attending physician was contacted to give them the information and suggest a palliative care consult. Quantitative and qualitative data were collected to evaluate the implementation of the tool including: number of PCSTs completed, disposition of the PCST, palliative care consults resulting from the PCST, reasons orders for palliative care were not written for patients meeting the criteria, and staff feedback. RESULTS: The tool successfully identified patients in need of PCT consultation; 46% of MICU and 12% of non-MICU patients met criteria for PCT consultation. PCT referrals from the MICU increased 4 fold in one year. Qualitative data showed that the tool was well-received in the MICU but was a burden to use on other units, primarily because of its length, complexity, and relatively small number of patients identified. The PCST data revealed ten primary patient criteria associated with PCT referral or "triggers". CONCLUSIONS: Use of a longer screening tool in the MICU was effective in identifying palliative care needs and increasing referrals to the PCT. Incorporating screening criteria or "triggers" into existing assessment tools for nursing, case management, social work and pastoral care services increased attention to palliative care needs and increased referrals to the PCT.en_GB
dc.date.available2011-10-26T19:26:11Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:26:11Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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