Medicine and Health Sciences Commons^™

Perspectives From Patients With Chronic Lung Disease On A Telehealth-Facilitated Integrated Palliative Care Model: A Qualitative Content Analysis Study, Jeannette Kates, Carrie Tompkins Stricker, Kristin L. Rising, Alexzandra Gentsch, Ellen Solomon, Victoria Powers, Venise J. Salcedo, Brooke Worster

Department of Medicine Faculty Papers

BACKGROUND: Chronic lung disease affects nearly 37 million Americans and often results in significant quality of life impairment and healthcare burden. Despite guidelines calling for palliative care (PC) integration into pulmonary care as a vital part of chronic lung disease management, existing PC models have limited access and lack scalability. Use of telehealth to provide PC offers a potential solution to these barriers. This study explored perceptions of patients with chronic lung disease regarding a telehealth integrated palliative care (TIPC) model, with plans to use findings to inform development of an intervention protocol for future testing.

METHODS: For this qualitative …

Data From Emergency Medicine Palliative Care Access (Empalla): A Randomized Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Telephonic Palliative Care Of Older Adults With Advanced Illness Presenting To The Emergency Department., Abigail M. Schmucker, Mara Flannery, Jeanne Cho, Keith S. Goldfeld, Corita Grudzen, Empalla Investigators

Student Papers, Posters & Projects

BACKGROUND: The Emergency Medicine Palliative Care Access (EMPallA) trial is a large, multicenter, parallel, two-arm randomized controlled trial in emergency department (ED) patients comparing two models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. This report aims to: 1) report baseline demographic and quality of life (QOL) data for the EMPallA cohort, 2) identify the association between illness type and baseline QOL while controlling for other factors, and 3) explore baseline relationships between illness type, symptom burden, and loneliness.

METHODS: Patients aged 50+ years with advanced cancer (metastatic solid tumor) or end-stage organ failure (New York …

Facing Death: Attitudes Toward Physician-Assisted End Of Life Among Physicians Working At A Tertiary-Care-Hospital In Israel, Keren Dopelt, Dganit Cohen, Einat Amar-Krispel, Nadav Davidovitch, Paul Barach

College of Population Health Faculty Papers

The demand for medical assistance in dying remains high and controversial with a large knowledge gap to support optimal patient care. The study aimed to explore physicians’ attitudes regarding euthanasia and examine the factors that related to these attitudes. We surveyed 135 physicians working at a tertiary-care hospital in Israel. The questionnaire was comprised of demographic and background information, DNR procedure information, encounters with terminally ill patients, familiarity with the law regarding end-of-life questions, and Attitudes toward Euthanasia. About 61% agreed that a person has the right to decide whether to expedite their own death, 54% agreed that euthanasia should …

To Anticoagulate Or Not: Decision Making Surrounding Anticoagulation In Patients In Hospice And Palliative Care Programs, Erin Kelly, Do, John Liantonio, Md, Mba, Hdmc, Debra Vermette, Md

Health Equity and Quality Improvement (HEQI) Summit

Objectives

• Describe the current guidelines for CAT treatment. - Assess risk factors for bleeding and thrombosis in cancer patients and risk/benefits of anticoagulation.
• Recognize the need for individualized anticoagulation plans in order to make informed decisions that may differ from the guidelines.
• Propose anticoagulation in hospice if it will achieve the goals of the patient.

Meaning-Centered Supervision: A Structured Self-Reflection Model To Reconnect With Personal And Professional Meaning In Palliative Care Work, Rebecca Cammy, Msw, Lcsw

Department of Medical Oncology Posters

Meaning-centered supervision explores participant’s sense of meaning of past, present, and future personal and professional experiences. The series aims to reintegrate selfreflection into clinical practice through experiential exercises, homework journaling, and group discussion. Social workers develop a narrative around themes of professional attitude, living and creating work life, and connections with the social work profession. The goal is to help palliative care social workers create a sense meaning and purpose in their work as they develop their personal and professional identities. Additionally, the hope is to support supervisees through any concerns of burnout and compassion fatigue.

Impact Of Palliative Care Consultation On End Of Life Care Measures: A Retrospective Analysis Of Patients In The Oncology Care Model, Alison Greidinger, Md, Maria Vershvovsky, Md, Evan Lapinsky, Md, Alison Rhoades, Md, Amy Leader, Drph, Vittorio Maio, Pharmd, Jared Minetola, Karen Walsh, Ms, Mba, Valerie Csik, Mph, Cpps, Ruben Rhoades, Md

Department of Medical Oncology Posters

Introduction

• In 2016 ASCO recommended that patients with advanced cancer receive dedicated palliative care (PC) services1. Early PC involvement is associated with lower spending, fewer 30-day readmission rates, decreased chemotherapy administration at the end of life (EOL) and increased hospice referrals2.
• Many patients are not referred and continue to receive chemotherapy and utilize high-acuity services near the EOL.
• The Oncology Care Model (OCM) is a CMS episode-based alternative payment model promoting high-value care.
• We evaluated the effect of PC visits on EOL outcomes including code status (CS) and spending in the last 30 days of life.

Development Of An Outpatient Palliative Care Protocol To Monitor Fidelity In The Emergency Medicine Palliative Care Access Trial., Corita R. Grudzen, Abigail M. Schmucker, Deborah J. Shim, Aminat Ibikunle, Jeanne Cho, Frank R. Chung, Susan E. Cohen

Student Papers, Posters & Projects

Introduction: Palliative care is recommended for patients with life-limiting illnesses; however, there are few standardized protocols for outpatient palliative care visits. To address the paucity of data, this article aims to: (1) describe the elements of outpatient palliative care that are generalizable across clinical sites; (2) achieve consensus about standardized instruments used to assess domains within outpatient palliative care; and (3) develop a protocol and intervention checklist for palliative care clinicians to document outpatient visit elements that might not normally be recorded in the electronic heath record.

Methods: As part of a randomized control trial of nurse-led telephonic case management …

Single-Subject Designs And Practice-Based Research In Palliative Care: A Letter To The Editor., James Gerhart, Dennis J. Hand, Michael Hoerger, Sean O'Mahony

Department of Obstetrics and Gynecology Faculty Papers

No abstract provided.

Emergency Medicine Palliative Care Access (Empalla): Protocol For A Multicentre Randomised Controlled Trial Comparing The Effectiveness Of Specialty Outpatient Versus Nurse-Led Telephonic Palliative Care Of Older Adults With Advanced Illness, Corita R. Grudzen, Deborah J. Shim, Abigail M. Schmucker, Jeanne Cho, Keith S. Goldfeld

Student Papers, Posters & Projects

Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement.

Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of …

A Provider-Based Survey On Quality Of Care And Identification Of Quality Gaps In Inpatient Palliative Care, Adam Pennarola, Md, Mph, Matthew Murphy, Md, Elizabeth Collins, Md, Beth Wagner, Msn, Crnp, Achpn, John Liantonio, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

Inpatient Palliative Care Teams (IPCTs) are often called upon to provide multidisciplinary care across hospital settings at Jefferson. However, there is currently no mechanism in place wherein providers consulting the IPCT can provide feedback to specialty palliative care clinicians. Such input from providers could be used to elucidate those services provided by the team which are most appreciated and those which require further development in order to be truly effective. Furthermore, such input may also serve to identify completely new areas for inpatient palliative care needs.

Acceptance And Commitment Therapy With Pancreatic Cancer: An Integrative Model Of Palliative Care-A Case Report., Catherine Virginia F O'Hayer, Kevin Mitchell O'Hayer, Ashwin Sama

Department of Medical Oncology Faculty Papers

Background: This case study examines the feasibility of application of an acceptance-based behavioral therapy, acceptance and commitment therapy (ACT), to a patient with end-stage metastatic pancreatic cancer, depression, and anxiety, as a form of integrative palliative care.

Case Presentation: ACT allowed the patient to identify her values of resuming her religious connection, improving relationships with family members and trusted friends, and organizing her affairs before death. As a result, the patient was able to remain engaged in cancer treatments despite side effects that she had previously deemed intolerable. She was able to move toward her values despite health-related and depression-related …

End-Of-Life Care: Crossing The Bridge From Treatment To Support, Martha C. Romney Bsn, Ms, Jd, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Diet And Nutrition In Cancer Survivorship And Palliative Care., Anthony J Bazzan, Andrew B Newberg, William C Cho, Daniel A Monti

Marcus Institute of Integrative Health Faculty Papers

The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a …

End Of Life Decision Making, Susan Parks Md

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Death Talk, Joanne Reifsnyder

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

A Culture Of Comfort: Palliative Care At Thomas Jefferson University Hospital, Barbara Reville Ms, Aprn, Bs

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Alleviating Pain: From Policy To Practice, Etienne J. Phipps

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Comfort Care In Advanced Alzheimer's Disease, Terri Maxwell, Susan Parks

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Beyond Pain Management: A Primer For Providing Quality End-Of-Life Care, Linda P. Tomko, Terri L. Maxwell

Department of Family & Community Medicine Faculty Papers

Providing excellent care for a dying patient is something all patients deserve. Hospices and palliative care centers exist in many areas to aid primary care physicians and patients through this difficult time. It is important to remember that most patients want to prepare for death, if at all possible. Everyone does this in his or her own way, but oftentimes concern about pain and symptom management interfere with this very involved and valuable process. Being prepared to treat these symptoms as well as addressing your patient's emotional needs is imperative. Referral to a hospice, if possible, will only strengthen the …

Ariel - Volume 11 Number 1, Ellen Blair, Rich Freeman, Dave Van Wagoner, Joan M. Greco, Lenny Nasca, Peter Waldron, Henry Doelen, Aaron Bleznak, Larry Blinn, Sam Markind, Martin Getzow, Ellen Feldman, Paul Davis, Andrew Curtin, Martin Getzow, Carl Shanholtz, Debbie Carter, Ron Brockman, Hugh Gelabert, Paul F. Mansfield, Beth Squires, Howie Fugate, Stuart Singer

Ariel

Executive Editors

Ellen Feldman

Leonardo S. Nasca, Jr.

Business Managers

Barbara L. Davies

Martin B. Getzow

News Editor

Aaron D. Bleznak

Features Editor

Dave Van Wagoner

CAHS Editor

Joan M. Greco

Editorial Page Editor

Samuel Markind

Photography Editor

Leonardo S. Nasca, Jr.

Sports Editor

Paul F. Mansfield

Ariel - Volume 10 Number 6, Mark Zwanger, Madalyn Schaefgen, J. Edward O'Brien, Melville Dui, Paul A. Bowers, Joe Stella, Allan Cummings, Stuart Singer

Ariel

Executive Editors

Madalyn Schaefgen

David Reich

Business Manager

David Reich

News Editors

Medical College

Edward Zurad

CAHS

John Guardiani

World

Mark Zwanger

Features Editors

Meg Trexler

Jim O'Brien

Editorials Editor

Jeffrey Banyas

Photography and Sports Editor

Stuart Singer

Commons Editor

Brenda Peterson

Ariel - Volume 6 Number 4 (Alternate Version), John Lammie, J.D. Kanofsky, Nancy Redfern, Deborah Boehm, Ken Jaffe, James L. Buckley, Bob Sklaroff, Morton A. Klein, Bob Sataloff, Wally Judd, Irving Olshin, Curt Cummings, H. S. Faust, Jim Burke, Robert Brent, Philip Nimoityn, R. Wing

Ariel

Editors

Mark Dembert

J.D. Kanofsky

Frank Chervenak

John Lammie

Curt Cummings

Entertainment

Robert Breckenridge

Joe Conti

Gary Kaskey

Photographer

Larry Glazerman

Overseas Editor

Mike Sinason

Humorist

Jim McCann

Staff

Kenn Jaffe

Bob Sklaroff

Halley Faust

Jim Burke

Jay Amsterdam

Morton A. Klein

Nancy Redfern

Ariel - Volume 6 Number 4, John Lammie, J.D. Kanofsky, Nancy Redfern, Deborah Boehm, Sheryl Lederman Silfen, Ken Jaffe, James L. Buckley, Bob Sklaroff, Morton A. Klein, Bob Sataloff, Wally Judd, Irving Oishin, Curt Cummings, Jim Burke, Robert Brent, Philip Nimoityn

Ariel

Editors

Mark Dembert

J.D. Kanofsky

Frank Chervenak

John Lammie

Curt Cummings

Entertainment

Robert Breckenridge

Joe Conti

Gary Kaskey

Photographer

Larry Glazerman

Overseas Editor

Mike Sinason

Humorist

Jim McCann

Staff

Ken Jaffe

Bob Sklaroff

Halley Faust

Jim Burke

Ariel - Volume 5 Number 6, Alec Gerson, Leo Riordan, Jay D. Amsterdam, Curtis Cummings, Lorraine Mueller, Mark Dembert, Larry Cook, David Mayer, Janet Welsh, Tom Carnwath, Gary Kaskey, Steve Glinka, Robert L. Breckenridge, Jr.

Ariel

Editors

J.D. Kanofsky

Mark Dembert

Entertainment

Robert Breckenridge

Joe Conti

Gary Kaskey

Photographer

Scot Kastner

Overseas Editor

Mike Sinason

Circulation

Jay Amsterdam

Humorist

Jim McCann

Staff

Ken Jaffe

Bob Sklaroff

Janet Welsh

Dave Jacoby

Phil Nimoityn

Frank Chervanek

Introductory Address Delivered Before The Students Of Jefferson Medical College, Philadelphia., Samuel Henry Dickson, Md, Lld

Jefferson Medical College Opening Addresses

No abstract provided.

Lecture Introductory To The Course On Materia Medica And General Therapeutics, In The Jefferson Medical College Of Philadelphia, Delivered October 13th 1857., Thomas D. Mitchell, Md

Jefferson Medical College Opening Addresses

No abstract provided.

Introductory For 1844-5, On The Present Position Of Some Of The Most Important Of The Modern Operations Of Surgery., Thomas Dent Mutter, Md

Jefferson Medical College Opening Addresses

No abstract provided.

Lecture Introductory To His Course Of Lectures For 1843-4., Charles D. Meigs, Md

Jefferson Medical College Opening Addresses

No abstract provided.