Medicine and Health Sciences Commons^™

The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel

Doctoral Projects

Objective: The purpose of this study is to examine if patients enrolled in multi-disciplinary intensive case management program (ImPACT) alter the patient’s end-of-life path or setting of death.

Methods: The quality improvement project is a quantitative retrospective study that compared patients receiving standard primary care vs intensive case management (ImPACT) during 2/2013-1/2014. It is a secondary analysis of a larger study of a quality improvement evaluation that took place at the Veterans Administration facility in Palo Alto, Ca.

Results: Among the 82 patients who died, 19 were enrolled in ImPACT for approximately 249 days compared to 63 who received standard …

An Educational Intervention To Increase Advance Directive Completion, Kimberly Harlow

Regis University Student Publications (comprehensive collection)

In the United States, it is common for patients to receive prolonged, aggressive medical care at the end of life (Levi & Green, 2010). This level of medical care may or may not be in alignment with patients’ wishes. Advance directives developed as a response to this situation. Despite the widespread availability of advance directives and the impetus for health care facilities to discuss advance directives with patients, most Americans do not have a completed advance directive. The average completion rate for advance directives in all populations in the United States is about 25% (Silveira, Witala, & Piette, 2014). This …

The Underuse Of Hospice Care In The African American Military Beneficiary Population, Wanda Castleberry Richards

Walden Dissertations and Doctoral Studies

Hospice services provide a holistic approach to end-of-life care to terminally ill patients though there is some evidence to suggest that African American military beneficiary populations may not access hospice care as often as expected. The purpose of this nonexperimental study was to evaluate reasons for the low use of hospice care among the terminally diagnosed members of this population, between the ages of 18 and 64. Kolcaba's comfort theory provided the theoretical framework for this study. The research explored whether a statistically significant difference exist among African Americans military beneficiaries population as compared to non-Hispanic Whites pertaining to their …