Development of Hospice and Palliative Medicine Knowledge and Skills for Emergency Medicine Residents: Using the Accreditation Council for Graduate Medical Education Milestone Framework

Shoenberger, Jan; Lamba, Sangeeta; Goett, Rebecca; DeSandre, Paul; Aberger, Kate; Bigelow, Suzanne; Brandtman, T.; Chan, Garrett K.; Zalenski, Robert J.; Wang, David; Rosenberg, Mark; Jubanyik, Karen

doi:10.1002/aet2.10088

Cited by 24 publications

(16 citation statements)

References 52 publications

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Section: Discussionmentioning

confidence: 99%

“…However, our findings do align with previously published literature reporting that although most emergency medicine clinicians have had little or no formal training in PC skills, they view palliative medicine as valuable in improving the care of patients in the ED, and have interest in more PC integration. 9,21,22 The highest response rate to any individual qualitative question related to the ideal model for ongoing PC in the ED (77 responses). The respondents unanimously wanted to see ongoing engagement of PC subspecialty clinicians in the ED.…”

Section: Discussionmentioning

confidence: 99%

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The Experience of Emergency Department Providers With Embedded Palliative Care During COVID

Aaronson

Petrillo

Stoltenberg

et al. 2020

Journal of Pain and Symptom Management

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Introduction Although the importance of palliative care (PC) integration in the Emergency Department (ED) has long been recognized, few formalized programs have been reported and none have evaluated the experience of ED clinicians with embedded PC. We evaluate the experience of ED clinicians with embedded PC in the ED during COVID. Methods ED clinicians completed a survey about their perceptions of embedded PC in the ED. We summarized responses to closed-ended items using descriptive statistics and analyzed open-ended items using thematic analysis. Results There were 134 ED clinicians surveyed. 101 replied (75% response rate). Of those that had interacted with PC, 100% indicated a benefit of having PC involved. These included freeing up ED clinicians for other tasks (89%), helping them feel more supported (84%), changing the patients care trajectory (67%), and contributing to clinician education (57%) and skills (49%). Among barriers related to engaging PC were difficulty locating them (8%) and lack of time to consult due to ED volume (5%). 98% of respondents felt that having PC in the ED was either “valuable” or “very valuable.” Open-ended responses reflected a positive impact on clinician wellness and improvement in access to high quality goal concordant care. Clinicians expressed gratitude for having PC in the ED and noted the importance of having readily available and easily accessible PC in the ED. Conclusion ED clinicians’ perception of embedded PC was overall positive, with an emphasis on the impact related to task management, enrichment of PC skills, providing support for the team, and improved care for ED patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Experience of Emergency Department Providers With Embedded Palliative Care During COVID

Aaronson

Petrillo

Stoltenberg

et al. 2020

Journal of Pain and Symptom Management

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“…In recent months, the American College of Emergency Physicians (ACEP) Palliative Medicine Section has developed a set of milestones, using the ACGME milestone framework, for hospice and palliative medicine for EM residents. 23 Our results suggest that we do not currently have a similar educational landscape in Canada.…”

Section: Discussionmentioning

confidence: 71%

Palliative and end-of-life care education in Canadian emergency medicine residency programs: A national cross-sectional survey

Baylis

Harris

Chen

et al. 2019

CJEM

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ObjectivesEmergency physicians play an important role in providing care at the end-of-life as well as identifying patients who may benefit from a palliative approach. Several studies have shown that emergency medicine (EM) residents desire further training in palliative care. We performed a national cross-sectional survey of EM program directors. Our primary objective was to describe the number of Canadian postgraduate EM training programs with palliative and end-of-life care curricula.MethodsA 15-question survey in English and French was sent by email to all program directors of both the Canadian College of Family Physicians emergency medicine (CCFP(EM)) and the Royal College of Physicians and Surgeons of Canada emergency medicine (RCPSC-EM) postgraduate training programs countrywide using FluidSurveys™ with a modified Dillman approach.ResultsWe received a total of 26 responses from the 36 (response rate = 72.2%) EM postgraduate programs in Canada. Ten out of 26 (38.5%) programs had a structured educational program pertaining to palliative and end-of-life care. Lectures or seminars were the exclusive choice to teach content. Clinical palliative medicine rotations were mandatory in one out of 26 (3.8%) programs. The top two barriers to implementation of palliative and end-of-life care curricula were lack of time (84.6%) and curriculum development concerns (80.8%).ConclusionsPalliative and end-of-life care training within EM has been identified as an area of need. This cross-sectional survey demonstrates that a minority of Canadian EM programs have palliative and end-of-life care curricula. It will be important for all EM training programs, RCPSC-EM and CCFP(EM), in Canada, to develop an agreed upon set of competencies and to structure their curricula around them.

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“…Alternatively, emergency physicians could team up with palliative care staff and work on the basis of previously established common goals; or advanced integration where they share the same physical space, goals, and protocols. Another option to consider is advanced integration where the EP would have the necessary skills, certified by a palliative care board to ensure appropriate training of the EP in the area of palliative medicine [14][15][16] . At present, none of these models have been established in Mexico or Latin America at any level of medical care.…”

Section: Revista Médica Del Hospital General De Méxicomentioning

confidence: 99%

Integration of palliative care to the emergency department. Management algorithm approach

Anica-Malagón¹,

Cordero-Pelayo²,

Salgado-Abrego³

et al. 2021

HGMX

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Regarding medical emergencies, physicians exclusively deal with seriously ill patients suffering from advanced, progressive, and chronic diseases, where the diagnostic and therapeutic approach becomes simultaneous. Sometimes with a very wide range of possibilities that lead to a greater complexity when identifying if the patient is in the last phase of life. Thus, there is a risk of falling into therapeutic obstinacy or disinterest leaving aside the main objective of ensuring the comfort of these patients. In response to this need, our work team carried out an algorithm that aims to integrate palliative care to the emergency service, by identifying end-of-life patients, in addition to implementing management proposals for each stage thereof.

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Development of Hospice and Palliative Medicine Knowledge and Skills for Emergency Medicine Residents: Using the Accreditation Council for Graduate Medical Education Milestone Framework

Cited by 24 publications

References 52 publications

The Experience of Emergency Department Providers With Embedded Palliative Care During COVID

The Experience of Emergency Department Providers With Embedded Palliative Care During COVID

Palliative and end-of-life care education in Canadian emergency medicine residency programs: A national cross-sectional survey

Integration of palliative care to the emergency department. Management algorithm approach

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