Discussing POLST-facilitated hospice care enrollment in patients with terminal cancer

An, Ho Jung; Jeon, Hyun Jeong; Chun, Sang Hoon; Jung, Hyun Ae; Ahn, Hee Kyung; Lee, Kyung Hee; Kim, Min‐ho; Kim, Ju Hee; Cheon, Jaekyung; Koh, Su‐Jin

doi:10.1007/s00520-022-07143-x

Cited by 2 publications

(2 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our analysis highlights the benefit associated with a MOLST in facilitating goal-concordant hospice transition, which is consistent with prior evidence . We postulate that the presence of a MOLST may be most influential in guiding surrogate decision-making related to hospice for patients with sudden, catastrophic illnesses.…”

Section: Discussionsupporting

confidence: 86%

“…[22][23][24][25] Our analysis highlights the benefit associated with a MOLST in facilitating goal-concordant hospice transition, which is consistent with prior evidence. 26,27 We postulate that the presence of a MOLST may be most influential in guiding surrogate decision-making related to hospice for patients with sudden, catastrophic illnesses. The intervention's lack of significance on the primary outcome after multivariable regression in the subgroup with neurologic diagnoses may have been due to the smaller sample (type II error).…”

Section: Jama Network Open | Emergency Medicinementioning

confidence: 99%

See 1 more Smart Citation

A Hospice Transitions Program for Patients in the Emergency Department

Baugh,

Ouchi,

Bowman

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

ImportancePatients often visit the emergency department (ED) near the end of life. Their common disposition is inpatient hospital admission, which can result in a delayed transition to hospice care and, ultimately, an inpatient hospital death that may be misaligned with their goals of care.ObjectiveTo assess the association of hospice use with a novel multidisciplinary hospice program to rapidly identify and enroll eligible patients presenting to the ED near end of life.Design, Setting, and ParticipantsThis pre-post quality improvement study of a novel, multifaceted care transitions program involving a formalized pathway with email alerts, clinician training, hospice vendor expansion, metric creation, and data tracking was conducted at a large, urban tertiary care academic medical center affiliated with a comprehensive cancer center among adult patients presenting to the ED near the end of life. The control period before program launch was from September 1, 2018, to January 31, 2020, and the intervention period after program launch was from August 1, 2021, to December 31, 2022.Main Outcome and MeasuresThe primary outcome was a transition to hospice without hospital admission and/or hospice admission within 96 hours of the ED visit. Secondary outcomes included length of stay and in-hospital mortality.ResultsThis study included 270 patients (median age, 74.0 years [IQR, 62.0-85.0 years]; 133 of 270 women [49.3%]) in the control period, and 388 patients (median age, 73.0 years [IQR, 60.0-84.0 years]; 208 of 388 women [53.6%]) in the intervention period, identified as eligible for hospice transition within 96 hours of ED arrival. In the control period, 61 patients (22.6%) achieved the primary outcome compared with 210 patients (54.1%) in the intervention period (P &lt; .001). The intervention was associated with the primary outcome after adjustment for age, race and ethnicity, primary payer, Charlson Comorbidity Index, and presence of a Medical Order for Life-Sustaining Treatment (MOLST) (adjusted odds ratio, 5.02; 95% CI, 3.17-7.94). In addition, the presence of a MOLST was independently associated with hospice transition across all groups (adjusted odds ratio, 1.88; 95% CI, 1.18-2.99). There was no significant difference between the control and intervention periods in inpatient length of stay (median, 2.0 days [IQR, 1.1-3.0 days] vs 1.9 days [IQR, 1.1-3.0 days]; P = .84), but in-hospital mortality was lower in the intervention period (48.5% [188 of 388] vs 64.4% [174 of 270]; P &lt; .001).Conclusions and RelevanceIn this quality improvement study, a multidisciplinary program to facilitate ED patient transitions was associated with hospice use. Further investigation is needed to examine the generalizability and sustainability of the program.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Jama Network Open | Emergency Medicinementioning

confidence: 99%

A Hospice Transitions Program for Patients in the Emergency Department

Baugh,

Ouchi,

Bowman

et al. 2024

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

Pediatric Oncology Hospice: A Comprehensive Review

Tafazoli,

Cronin-Wood

2024

Am J Hosp Palliat Care

View full text Add to dashboard Cite

Pediatric hospice is a new terminology in current medical literature. Implementation of pediatric hospice care in oncology setting is a vast but subspecialized field of research and practice. However, it is accompanied by substantial uncertainties, shortages and unexplored sections. The lack of globally established definitions, principles, and guidelines in this field has adversely impacted the quality of end-of-life experiences for children with hospice needs worldwide. To address this gap, we conducted a comprehensive review of scientific literature, extracting and compiling the available but sparse data on pediatric oncology hospice from the PubMed database. Our systematic approach led to development of a well-organized structure introducing the foundational elements, highlighting complications, and uncovering hidden gaps in this critical area. This structured framework comprises nine major categories including general ideology, population specifications, role of parents and family, psychosocial issues, financial complications, service locations, involved specialties, regulations, and quality improvement. This platform can serve as a valuable resource in establishing a scientifically reliable foundation for future experiments and practices in pediatric oncology hospice.

show abstract

Discussing POLST-facilitated hospice care enrollment in patients with terminal cancer

Cited by 2 publications

References 31 publications

A Hospice Transitions Program for Patients in the Emergency Department

A Hospice Transitions Program for Patients in the Emergency Department

Pediatric Oncology Hospice: A Comprehensive Review

Contact Info

Product

Resources

About