Palliative Care Commons^™

We Grow Accustomed To The Light, Minh Q. Nguyen

HCA Healthcare Journal of Medicine

Drawing inspiration from Emily Dickinson’s exploration of the unknown in "We Grow Accustomed to the Dark," this poem, "We Grow Accustomed to the Light," re-examines the final transition of life through a clinical and humanist lens. While Dickinson focused on the bravery required to navigate the "Dark," this piece explores the courage needed to face the "Light," representing the clarity of terminal illness, the shedding of medical "fetters," and the shared experience of the "final goodbye." It challenges the traditional medical impulse to "push forward" at all costs, instead advocating for a "Wise" acceptance of the natural end of the …

Impact Of Palliative Care Consultation On Clinical Interventions And Outcomes In A Medical-Surgical Community-Based Intensive Care Unit, Manjot S. Malhi, Jude Tabba, Aunie M. Danyalian, Michele Iguina, Daniel Zapata, Raiko Diaz, Dionne Morgan, Daniel Heller, Sanaz Kashan, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Integrating palliative care into intensive care unit (ICU) practice is an essential component of comprehensive patient management, ensuring that critical interventions are aligned with patient-centered care objectives. This study aims to evaluate the impact of palliative care consultation (PCC) on clinical interventions, patient outcomes, and decision-making processes in a community-based medical-surgical ICUs.

Methods

We conducted a prospective, observational, single-center cohort study of critically ill adult patients in a community-based medical-surgical ICU. Patients were grouped by the presence (PCCP) or absence (PCCA) of palliative care consultation. Primary outcomes included differences in clinical interventions (mechanical ventilation, vasoactive medications, renal replacement therapy, …

Suicidality, Self-Neglect, And Medical Refusal In Advanced Illness: An Ethical Case Report, Austin Supak, Sarah Greene, Madeline Adelman, Whitney Snyders

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

Limited English Proficiency And Quality Of Hospice Care: A Retrospective-Cross Analysis, Carol Elsakr, Stephen Meyer

South Atlantic Division GME Research Days 2026

No abstract provided.

Improving The Utilization Of Palliative Care Services At Medical City Fort Worth, Gennipher Smith, Shervin Sarji, Maanasa Palani, Samuel Chen, Mary Halm, Kristina Bowman, Morvarid Rezaie

North Texas GME Research Forum 2026

Palliative Care (PC) is a specialized medical care that aims to optimize the quality of life and alleviate the suffering of patients with serious medical illness. Benefits of palliative care include improved symptom management, enhanced quality of life, reduced healthcare utilization, better care alignment, improved communication and support, and financial savings. Hospital Corporation of America (HCA) Medical City Fort Worth (MCFW) has a PC consult service. However, it is underutilized. According to data collected from January 2025 to December 2025, the percentage of PC consults for high risk units, such as oncology and ICU, by day 3 of admission varies …

Subanesthetic Ketamine Use For Uncontrolled Pain In Hospice Care, Tiffany Rey, Ana Sanchez

South Atlantic Division GME Research Days 2026

No abstract provided.

Utilization Of Multimodal Therapy Including Ketamine And Methadone In Cancer-Related Pain: A Case Report, Austin Mccrea, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

Quick Improvement In Delirium In A Patient With Parkinson's Disease Through Rectally Administered Carbidopa/Levodopa: A Case Report, Emil Philip, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

Persistent Racial And Sex-Based Disparities In Radiation Receipt And Survival Among Patients With Anal Cancer, Yashaswi Koguru, Austin Mccrea, Stephen Meyer

South Atlantic Division GME Research Days 2026

No abstract provided.

Impact Of Early Palliative Care Consultations On Hospital Length Of Stay And In-Hospital Mortality, Renuka Mahatara, Lisa Michelson, Faris Mohammed, Des'ree Garvin

South Atlantic Division GME Research Days 2026

No abstract provided.

Capacity Over Cognition: A Case Of High-Risk Disease And Homelessness, Mikalah E. Maury, Avery M. Duncan, Rebecca A. Taylor, Mary Ann Beil, Maulikkumar A. Patel

HCA Healthcare Journal of Medicine

Background

Medical decision-making in indigent patients with baseline cognitive deficits and lack of supportive resources is a difficult problem that reveals many ethical issues. Performing high-level medical procedures (eg, invasive surgery, chemotherapy, radiation therapy) on these patients without supportive resources brings into question the efficacy and necessity of treatment if it places the patient at higher risk of additional complications and mortality.

Case Presentation

In this article, we present a case of a 62-year-old indigent man with a long history of encephalopathy secondary to alcohol abuse, presenting with an aggressive head and neck cancer impacting his quality of life.

Conclusion …

Ethical Considerations Of Percutaneous Endoscopic Gastrostomy Tube Placement In A Patient With Creutzfeldt-Jakob Disease And Advanced Dementia, Toni Habib, Niamh Siobhán Mulrooney, Yisroel Grabie, Mohammad Maruf, Sophia Kasapira

HCA Healthcare Journal of Medicine

Background

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive neurodegenerative condition that is not easily diagnosed and has no curative treatments available, essentially requiring palliative measures, including tube feeding. Nonetheless, data shows that the endoscope used for percutaneous endoscopic gastrostomy (PEG) tube insertion can be a vector for CJD transmission.

Case Presentation

We discuss the case of an elderly patient diagnosed with CJD, requiring tube feeding. Multiple specialists were consulted, and they were unable to reach an agreement on the best approach. Eventually, the hospital ethics committee intervened, and the family agreed to comfort measures only. This case report sheds light …

Impact Of A Comprehensive Palliative Quality Improvement Initiative (Icu-Pal) In A Medical-Surgical Intensive Care Unit, Aunie M. Danyalian, Michele M. Iguina, Manjot Malhi, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Early palliative care practice implementation in the intensive care unit (ICU) improves advance care planning, promotes patient and family satisfaction, and decreases health care costs. The consensus for protocolized palliative care delivery is unknown. We assessed the impact of a qualitive improvement educational intervention that promotes the identification of critically ill patients who will benefit from early expert palliative care interventions.

Methods

In this observational study, we examined the impact of an educational intervention that promoted (1) early detection of palliative care triggers (PCT) during ICU multidisciplinary rounds (MDRs), (2) admission and 48-hour pain assessment, and (3) family meetings …

Enhancing End Of Life Care Through Recognition & Flagging Of Imminence To Increase Visits, Ali Ahmed, Guru Chinnaraj, Ana Goncalves, Ahad Ahmed, Ezekiel Ijaopo, Joseph Shega, Diana Tren

North Florida Division GME Research Day 2025

No abstract provided.

Finding Grace With Advanced Cirrhosis: Improving Palliative Care Consult Utilization Final Results, Saud Khan, Samuel Kwiatkowski, Anjali Lukose, Amanda T. Rivera Miranda, Priscilla Phan, Ashwini Komarla, Sabiha Kazi, Diana Treu, Amar Mandalia

North Florida Division GME Research Day 2025

No abstract provided.

Has The Elimination Of Mandatory Buprenorphine X-Waiver Increased Presciptions Of This Medication Upon Discharge From The Hospital?, Kendall Moore, Robyn Meadows, Robyn Hoelle, Matthew Calestino

North Florida Division GME Research Day 2025

No abstract provided.

Comparing Chatgpt And Deepseek For Deprescription Support In Geriatric And Palliative Care: An Exploratory Study Using Clinical Vignettes, Gokhan Demir, Angel Sanchez, Sanaz Kashan

East Florida Division GME Research Day 2025

Background: Polypharmacy is common in older adults and increases risks of adverse drug events, falls, and hospitalizations. Deprescription can mitigate these harms but is often hindered by time constraints, fragmented guidelines, and complex comorbidities. Artificial intelligence (AI) large language models (LLMs) may provide decision-support for deprescription in geriatric and palliative care.

Objective: To compare ChatGPT and DeepSeek in their deprescription recommendations across standardized polypharmacy vignettes.

Methods: Three validated clinical vignettes, varied by activities of daily living (ADL) status and cardiovascular disease (CVD) history, were presented to ChatGPT (GPT-4/5) and DeepSeek (2024 version). Each vignette was tested in three replicates per …

Characteristics Of Patients Hospitalized To Community Hospitals With Malignant Brain Tumors And Factors Associated With Discharge Destination, Se Won Lee, Thanapath D. Thantacheva, Denny Mack

HCA Healthcare Journal of Medicine

Background

Our main objective was to compare the characteristics and hospital outcomes of patients with primary and metastatic brain malignancies and to investigate the associated factors related to hospital outcomes.

Methods

We conducted a retrospective, cross-sectional study of 1628 patients with brain malignancies from 8 community hospitals between 2017 and 2022 who were identified using International Classification of Disease codes. A stepwise logistic regression was used to identify demographics and clinical characteristics associated with in-hospital mortality and home discharge.

Results

The median age was 65 years old, with 72.5% of patients having metastatic brain malignancies. After 7.2 days of hospital …

Evaluating The Impact Of Early Palliative Care Consultations On 30-Day And 90-Day Readmissions Among Patients With Decompensated Cirrhosis: A National Perspective, Aya Akhras, Saadia Nabi, Kristen Santana, Mohammed Akram, Mahesh Tummala, Carmen Tormo Carrillo, Luis Santiago Zayas, Waseem Wahood, Sinay A. Ceballos, Deannys Batista, Alisha Menon, Bernardo J. Reyes, Franklin Kasmin

East Florida Division GME Research Day 2024

No abstract provided.

Eye Care For Corneal Transplant Donors In The Icu: What We Didn’T See Coming, Ashton Lackey, Joey Royea, Alexandra Hartman, Aaron Worthley, Abbi Mason, Bryan Howington, Bharat Meenavalli, George Helmrich, Stephen M. Meyer

South Atlantic Division GME Research Day 2024

No abstract provided.

Establishing A Protocol For Hospice Compassionate Withdrawal Of Ventilatory Support In The Home Setting, Georganna Rosel, Ana Sanchez, Reuben Smith

South Atlantic Division GME Research Day 2024

No abstract provided.

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

When We Pause: On The Discontinuation Of Enteral Feeding In Head And Neck Cancer A Case Report, Kyle Fisk, Ana Sanchez

South Atlantic Division GME Research Day 2023

No abstract provided.

Improving Comfort And Confidence With Advance Care Planning In Primary Care, Thomas Krajewski, Donald Courtney, Tyler Kilgore

South Atlantic Division GME Research Day 2023

No abstract provided.

Medication Cost Reduction And Substitution Strategies Through The Mymetrx Program At Catholic Hospice, Ana M. Sanchez Monroig, Tracy Romanello, Joseph Solien, Sanaz Kashan, Angel E. Sanchez Artiles

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Introduction: As healthcare costs continue to rise, and with the growing awareness of the potential harms of polypharmacy, there is an ongoing need to explore strategies to optimize medication use in hospice settings. Strategies include deprescribing and medication substitutions, which ensure the safety and comfort of patients but can also lead to significant medication cost reduction.

Objectives: The primary objective of this study was to evaluate the impact of the MyMetRx program on medication cost reduction and medication substitutions within the context of Catholic Hospice. The program aimed to optimize medication …

The Effect Of Early Palliative Care Consultation For Patient With Traumatic Brain Injury On Procedure Utilization, Length Of Stay And Discharge Location, Abdulelah Almutairi, Donald Courtney, Heather Rhodes

South Atlantic Division GME Research Day 2023

No abstract provided.

Incidence Of Adult (≥40y) Traumatic Intracranial Bleeding And Likelihood Of Routine Discharge: Do Co-Morbidities Matter?​, Stephanie Anderson, Heather Rhodes, Antonio Pepe, Donald Courtney

South Atlantic Division GME Research Day 2022

No abstract provided.

Palliative Privacy, Lina Fernandez, Jarratt Burton Banks, Stephen Meyer

South Atlantic Division GME Research Day 2022

No abstract provided.