Palliative Care as Essential to a Hospital System's Pandemic Preparedness Planning: How to Get Ready for the Next Wave

Gelfman, Laura P.; Moreno, Jaison; Chai, Emily

doi:10.1089/jpm.2020.0670

Cited by 9 publications

(21 citation statements)

References 5 publications

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“… 10 , 13 , 19 - 23 , 25 , 26 Of 6 discussion articles identified, 2 examined bereavement risk 17 , 24 1 presented the challenges experienced in delivering palliative services during a pandemic 12 and 3 discussed the implementation of a strategy or plan that was developed in their hospital to address the impact of the surge in palliative care patients. 15 , 18 , 27 One article presented a patient case study of the challenges and difficulties that were identified in a non-ICU setting. 11 Fiorentino et al (2020) 16 conducted a retrospective observational study using the Palliative Performance Scale (PPS) to predict mortality in 334 hospitalised patients with COVID-19.…”

Section: Resultsmentioning

confidence: 99%

“…The overall strategies and logistics adopted to address the surge in demand for palliative care was reported by 3 articles from the USA and 1 from Canada. 12 , 15 , 18 , 27 Each outlined a strategic plan that was adopted and focussed primarily on how to increase the numbers of palliative care staff as well as optimising the use of existing palliative care specialists. Some novel ways of addressing this problem were reported.…”

Section: Resultsmentioning

confidence: 99%

“…What was also apparent from these papers was the necessity for very quick training of staff not specialised in palliative care that worked in key areas such as ED or ICU to enhance their frontline skills via new tailored communication trainings. 18 Fausto et al (2020) 15 reported that all teams in ED, ICU and acute care services were provided with clinician discussion tools and access to consultation with the specialist palliative care team for assistance with complex communication. These frontline staff were provided with resources that included an informed assent strategy for discussing do-not-resuscitate orders as well as resources for COVID-19 ready communication skills.…”

Section: Resultsmentioning

confidence: 99%

“…A 24-hour/afterhours telephone service was established to provide additional palliative care capacity to primary care teams in relation to symptom guidance and coaching 15 and to patient’s families. 18 Specific end-of-life care units for patients dying with COVID-19 staffed by palliative care clinicians and advanced practice specialists were created 15 or modified 18 to maximise patient comfort and staff safety.…”

Section: Resultsmentioning

confidence: 99%

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Hospital-Based Palliative and End-of-Life Care in the COVID-19 Pandemic: A Scoping Review

Connolly

Bell

Lawler

et al. 2021

Am J Hosp Palliat Care

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Aim: To identify the nature of the evidence reporting hospital-based palliative and end-of-life care during the COVID-19 pandemic. Background: The COVID-19 pandemic has seen an increase in the numbers of seriously ill people being cared for across all health services worldwide. Due to the rapid progression of severe symptoms, the majority of staff working in hospitals and other healthcare centres were providing end-of-life care. Little is known about the level of hospital-based palliative care service provided during the COVID-19 pandemic, particularly during surges in admission rates with an increased number of deaths accruing. Methods: A scoping review was conducted to search and select potential studies. The scoping review was guided by the framework of Arskey and O’Malley and advanced by the use of the methodology of the Joanna Briggs Institute. Results: Eighteen studies published between March 2020 and July 2021 were identified. Three broad categories included overall management strategy and logistics, symptom prevalence and management of patients with COVID-19 and end-of-life care needs within the current pandemic. Conclusions: This review highlights increased awareness and knowledge of palliative and end-of-life care provided in hospitals. The review also highlights the response of hospital-based palliative care teams to an evolving crisis, within the context of developed health systems under sustained and overwhelming pressure. Implications: Newly established clinical links and referral pathways developed during the initial COVID-19 surge between hospital-based palliative care and other healthcare teams, be continued and further enhanced. Understanding of the role of specialist palliative care providers in supporting palliative and end-of-life care within the hospital setting needs further investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Hospital-Based Palliative and End-of-Life Care in the COVID-19 Pandemic: A Scoping Review

Connolly

Bell

Lawler

et al. 2021

Am J Hosp Palliat Care

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show abstract

“… 10 Therefore, palliative care teams, including that in our health system, expanded due to escalating need during the COVID-19 pandemic. 11 - 14…”

Section: Introductionmentioning

confidence: 99%

Palliative Care and Neurology Needs in Patients With and Without COVID-19

Crooms

Ankuda

2022

Am J Hosp Palliat Care

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Background The COVID-19 pandemic led to increased neurology and palliative care needs. We compare the characteristics of COVID-19 positive vs negative patients who received consultation by neurology and palliative care services during the 2020 COVID-19 surge in New York City to see how the groups differ in their consultation needs and to identify opportunities to improve care. Methods This retrospective analysis was performed within a multi-center hospital system in New York City, USA over a 2-month period (15 March to 15 May, 2020) which represented the peak of the first COVID-19 wave. Hospitalized patients who received a consultation from neurology and palliative care services were included. The patients were classified according to COVID-19 status (positive or negative based on PCR testing). Data abstracted from chart review included demographic data, details of neurology and palliative care consultations, duration of admission, ICU admission, intubation, code status, and death. Results The study included 70 patients who tested positive for COVID-19 and 39 patients who tested negative for a total of 109 patients. Compared to the patients who tested negative for COVID-19, the patients who tested positive for COVID-19 were more likely to have palliative care consultation for management of goals of care (70 [100%] vs 33 [84.6%], P = .003) and less likely for management of symptoms (2 [2.9%] vs 7 [17.9%], P = .02). Conclusion The findings emphasize the need for collaboration between palliative care and neurology, which was heightened during the COVID-19 pandemic. There was a particular need for communication surrounding goals of care.

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Lessons Learned from an Embedded Palliative Care Model in the Medical Intensive Care Unit

Mehta¹,

Krishnasamy²,

Chai³

et al. 2023

Journal of Pain and Symptom Management

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Palliative Care as Essential to a Hospital System's Pandemic Preparedness Planning: How to Get Ready for the Next Wave

Cited by 9 publications

References 5 publications

Hospital-Based Palliative and End-of-Life Care in the COVID-19 Pandemic: A Scoping Review

Hospital-Based Palliative and End-of-Life Care in the COVID-19 Pandemic: A Scoping Review

Palliative Care and Neurology Needs in Patients With and Without COVID-19

Lessons Learned from an Embedded Palliative Care Model in the Medical Intensive Care Unit

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