The American journal of hospice & palliative care最新文献

{"title":"Opportunities for Incorporation of Primary Palliative Care in Acute Care Surgery: A Narrative Review.","authors":"Anna Y Lynn, Samuel M Miller, Alexandria Brackett, Lisa M Kodadek","doi":"10.1177/10499091241309087","DOIUrl":"https://doi.org/10.1177/10499091241309087","url":null,"abstract":"<p><strong>Background: </strong>Palliative care is highly relevant to acute care surgery due to the patient populations and severity of illness. Efforts to routinely incorporate palliative care principles in the practice of acute care surgery by the primary surgical team may benefit patients and their families.</p><p><strong>Methods: </strong>We present a narrative review of the literature examining the current state of incorporation of primary palliative care in acute care surgery, including basic principles and strategies, evolving approaches, limitations, and opportunities for growth.</p><p><strong>Results: </strong>Implementation begins with early identification of patients who may benefit from primary palliative care. Primary palliative interventions may include medical symptom management, patient and caregiver support, and use of frameworks for communication in the setting of severe illness. Significant barriers to primary palliative care practice exist, including institutional differences in approaches to primary palliative care, socioeconomic and cultural factors, and varying patient and clinician perspectives about the role of primary palliative care. Over the last few decades, there has been increased awareness of a role for primary palliative care in acute care surgery, leading to recent advances in quality, education, and advocacy.</p><p><strong>Conclusions: </strong>Despite the known benefits of primary palliative care, it is still underutilized in acute care surgical patients. Shifting attitudes toward primary palliative care are helping to increase its use in surgical settings as well as promote education for surgical trainees. However, it is important to recognize the many opportunities for improvement of primary palliative care incorporation in acute care surgery.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091241309087"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Disparities in Hospice-Home Health Transitions in Hispanic Older Adults With Co-occurring Dementia and Cardiovascular Disease.","authors":"Sharon E Bigger, Kathy Howard Grubbs, Yan Cao, Gail L Towsley","doi":"10.1177/10499091241305395","DOIUrl":"https://doi.org/10.1177/10499091241305395","url":null,"abstract":"<p><strong>Purpose: </strong>In the US, nearly one-third of skilled home health (HH) patients and nearly one-half of hospice patients live with Alzheimer's disease and related dementias (ADRD). Hispanic older adults are more likely to live with ADRD than white non-Hispanic older adults. Persons with ADRD, compared to their counterparts without ADRD, have a prolonged trajectory of decline and experience multiple care transitions between health care settings, bringing risks for poor outcomes. Little is known about patients transitioning between skilled HH and hospice. We aimed to determine if there were demographic and/or diagnostic variables associated with the frequency of transitions between skilled HH and hospice.</p><p><strong>Design: </strong>In a cross-sectional study, we used Medicare claims data from 2020 and descriptive statistics including Chi-Square to determine demographic and diagnostic differences in frequency of care transitions between skilled HH and hospice for older adults with ADRD.</p><p><strong>Findings: </strong>In N = 272,323 hospice episodes, Hispanic older adult beneficiaries with ADRD and co-occurring cardiovascular disease (CVD) had significantly higher rates of care transitions from hospice to skilled HH (<i>P</i> = 0.037) than other racial and ethnic groups with both diagnoses.</p><p><strong>Conclusions: </strong>Our findings provide evidence of disparities in care transitions from hospice to skilled HH for Hispanic older adults living with ADRD and CVD. Multiple factors may impact this result: Hospice low quality scores, insufficient advance care planning and understanding of hospice philosophy, and policies affecting eligibility. Implications include policy change and greater coordination of care for older adults with co-occurring ADRD and CVD, with attention to health equity.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091241305395"},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Correlation Between Palliative Care Training in Brazil and Compassion Fatigue: A Cross-Sectional Study.","authors":"Gabriela Vieira Lucio, Gabriela Rodrigues de Oliveira Lima, Ana Júlia Dias Faustino, Camila Wenceslau Alvarez, Eliana Marangoni, Agnes Cruvinel, Thiago Cruvinel, Sabrina Corrêa da Costa Ribeiro, Julio Cesar Garcia Alencar","doi":"10.1177/10499091241305634","DOIUrl":"https://doi.org/10.1177/10499091241305634","url":null,"abstract":"<p><strong>Background: </strong>The literature lacks conclusive evidence regarding whether palliative care training confers a protective or predisposing influence on compassion fatigue. The present study hypothesizes that training in palliative care is associated with minor compassion fatigue levels among physicians and an improvement in their confidence in several procedures.</p><p><strong>Aim: </strong>To explore the physicians experiences with and without palliative care training who work as general practitioners in order to assess the prevalence of compassion fatigue in these groups.</p><p><strong>Methods: </strong>This is a quantitative and qualitative cross-sectional survey. For data analysis, Mann-Whitney and Pearson's chi-squared test tests were used considering <i>P</i> < 0.05 for significance.</p><p><strong>Results: </strong>The majority respondents had no training in palliative care (77.8%), however, 58.3% declared that they cared for at least 1 palliative care patient every 2 shifts - an intermediate frequency in our analysis. Trauma levels among doctors were classified as medium (24 ± 6), burnout as low (19 ± 5) and compassion as medium (41 ± 5). Professionals without training in palliative care had higher rates of burnout (<i>P</i> = 0.002), but there was no association between training and rates of trauma or compassion.</p><p><strong>Conclusions: </strong>Doctors with training in palliative care in Brazil showed lower burnout rates when working as general practitioners in secondary hospitals. This could instigate the implementation of educational programs in palliative care at hospitals and the further development of the field so as to improve professionals' performance at patients' treatment. There was no difference between Trauma and Compassion scores.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091241305634"},"PeriodicalIF":0.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Status of and Barriers to Primary Palliative Care Recognized by Critical Care Specialist Nurses: A Nationwide Cross-Sectional Questionnaire Survey in Japan.","authors":"Akane Kato, Yuta Tanaka, Yoshiyuki Kizawa, Hiroaki Yamase, Asami Tado, Junko Tatsuno, Mitsunori Miyashita","doi":"10.1177/10499091241303675","DOIUrl":"https://doi.org/10.1177/10499091241303675","url":null,"abstract":"<p><p><i>Objectives:</i> To investigate the current state of primary palliative care practice in Japanese critical care settings, identify care perceived as equivalent to primary palliative care, and explore the barriers. <i>Methods:</i> We employed a quantitative descriptive questionnaire survey with a nationwide cross-sectional design involving 740 critical care specialist nurses. <i>Results:</i> Questionnaires were received from 384 nurses, yielding a response rate of 51.9%. Nurses recognized typical palliative care provided to cancer patients, such as \"relieving suffering at end-of-life\" (95.3%), \"pain management\" (88.8%), and \"caring for patients' psychological suffering\" (88.3%), as primary palliative care in the critical care setting. They also recognized \"monitoring and management of delirium\" (68.5%), \"caring for patients' social suffering\" (63.5%), and \"preventing post-intensive care syndromes\" (61.7%) less frequently as aspects of primary palliative care in critical care settings. Additionally, the recognition was lower among emergency department nurses than intensive care unit nurses. The nurses recognized inadequate overall palliative care practices, especially regarding patients' social (72.1%) and spiritual (76.8%) suffering. They recognized \"insufficient knowledge and skills among critical care medical staff\" (70.6%) and \"unable to confirm the patients' preferences to treatment goals\" (54.4%) as barriers to providing primary palliative care. The barriers that nurses recognized less often were \"uncertainty about palliative care in critical care settings\" (6.8%) and \"disagreements among nursing teams regarding providing palliative care\" (8.3%). <i>Conclusion:</i> Specialist nurses understood palliative care but felt unprepared in primary palliative care due to limited knowledge. Improved education in primary palliative care and patient-family communication is needed in Japan's critical care settings.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"10499091241303675"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Management Review Committee: Fostering Interdisciplinary Education and Support Amid the Ongoing US Opioid Overdose Crisis.","authors":"Kyle Neale, Renato V Samala, Ruth Lagman, Patricia B Mullan, Laura Shoemaker","doi":"10.1177/10499091241230295","DOIUrl":"10.1177/10499091241230295","url":null,"abstract":"<p><strong>Background: </strong>Over the past two decades, pain and suffering caused by the U.S. opioid crisis have resulted in significant morbidity, policy reforms and healthcare resource strain, and affected healthcare providers' efforts to manage their patients' pain. In 2017, Cleveland Clinic's Department of Palliative and Supportive Care established their Opioid Management Review Committee (OMRC), which focuses on patient safety, opioid stewardship, education on specialist pain management and addiction medicine skills, and offers emotional and informational support to colleagues managing complex pain cases.</p><p><strong>Objectives: </strong>This quality assessment and improvement activity describes the organization and effects of the OMRC on healthcare workers in the department.</p><p><strong>Methods: </strong>On February 1, 2023, an online survey was distributed to attendees of the OMRC. Participants were asked to provide their demographic information and free text responses to questions about the purpose of the OMRC, their judgment about the extent to which the OMRC has changed their approach to pain management, the OMRC's impact on their approach to opioid management, its impact on the clinicians' confidence in managing nonmedical opioid use or comorbid substance use, and suggestions to improve future meetings.</p><p><strong>Results: </strong>Fifty-nine out of 79 clinicians completed the survey (75% response rate). Participants' aggregate responses indicated that the committee fostered interdisciplinary collaboration, provided emotional and professional support, increased awareness of responsible opioid prescribing, and enhanced confidence in managing complex cases involving non-medical opioid use or comorbid substance use.</p><p><strong>Conclusion: </strong>The OMRC represents a comprehensive interdisciplinary approach to safely manage opioid therapy during the contemporary opioid overdose crisis.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"1459-1466"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Experiences of Perinatal Palliative Care After a Stillbirth: A Narrative Therapy for Grief.","authors":"Yanhua Liu, Xiaolin Yang, Xiaoxiong Zhu, Xiaoling Tian, Zhifen Yang","doi":"10.1177/10499091241228976","DOIUrl":"10.1177/10499091241228976","url":null,"abstract":"<p><p>Narrative care for families suffering from perinatal loss is rarely provided by medical institutions in China Mainland. However, with the advancement of the Chinese narrative medicine theory and practice, the clinical significance of narrative care has been increasingly recognized. Based on the principles of Chinese narrative medicine, this narrative case study described traumatic narrative foreclosures occuring in a family suffering from stillbirth, and highlighted the multidisciplinary collaboration for practising narrative care in the process of supporting the bereaved in our hospital. Meanwhile, we advocate the establishment of a narrative care ecology by training more obsteticians and nurses with good narrative competence in purpose of helping the family experiencing perinatal losses to overcome their tramatic narrative foreclosures, increasing the chances of another successful pregnancy and childbirth as well as enhancing their quality of life.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"1511-1516"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Hospice Care Structures on Care Processes: A Retrospective Cohort Study.","authors":"Everlien de Graaf, Matthew Grant, Frederieke van der Baan, Marieke Ausems, Carlo Leget, Saskia Teunissen","doi":"10.1177/10499091241228254","DOIUrl":"10.1177/10499091241228254","url":null,"abstract":"<p><p><b>Background:</b> Palliative care is subject to substantial variations in care, which may be shaped through adapting the organisational structures through which care is provided. Whilst the goal of these structures is to improve patient care, there is a lack of evidence regarding their effect on care processes and patient outcomes. <b>Aims:</b> This study aims to describe the relationship between care structures and the quantity and domains of care processes in hospice care. <b>Design:</b> Retrospective cohort study. <b>Settings/Participants:</b> Data were collected from Dutch hospice patient's clinical records and hospice surveys, detailing hospice structures, patient clinical characteristics and care processes. <b>Results:</b> 662 patients were included from 42 hospices, mean age 76.1 years. Hospices were categorised according to their care structures - structured clinical documentation and multidisciplinary meetings. Patients receiving care in hospices with structured multidisciplinary meetings had an increased quantity of documented care processes per patient on admission through identification (median 4 vs 3, <i>P</i> < .001), medication (2 vs 1, <i>P</i> = .004) and non-medication (1 vs 0, <i>P</i> < .001) interventions, monitoring (2 vs 1, <i>P</i> < .001) and evaluation (0 vs 0, <i>P</i> = .014), and prior to death. Similar increases were identified for patients who received care in hospices with structured documentation upon admission, but these changes were not consistent prior to death. <b>Conclusions:</b> This study details that the care structures of documentation and multidisciplinary meetings are associated with increased quantity and breadth of documentation of care processes in hospice care. Employing these existing structures may result in improvements in the documentation of patient care processes, and thus better communication around patient care.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"1423-1430"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11453027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139486899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Home Hospice Care Needs Questionnaire for the Dying Old Adult (HHCNQ-DE) in Mainland China.","authors":"Lei Wang, Yaru Li, Rui Zhao, Jiangxu Li, Xiangru Gong, Hongyu Li","doi":"10.1177/10499091231223486","DOIUrl":"10.1177/10499091231223486","url":null,"abstract":"<p><p><i>Context</i>: Home hospice needs assessment is the key to the development of home hospice services. Therefore, there is a need to develop assessment tools in mainland China to meet the comprehensive needs of the old adult at the end of life. <i>Objective</i>: To develop and validate a tool to assess Chinese mainland palliative care needs of the dying old adult at home. <i>Methods</i>: Using the Harmony Nursing Theory as a theoretical framework, through reference to the China home hospice care needs scale, literature research, in-depth conversations with the dying old adult, and group discussions among members of the research team, 43 original questionnaire items were preliminarily drafted. A 31-item predictive questionnaire was formed through 2 rounds of expert review and small sample testing. From April to September 2023, 199 old adult at the end of life at home in Jinzhou, Liaoning Province were investigated to determine the reliability and validity of the questionnaire. <i>Results</i>: The final questionnaire included 31 items. Exploratory factor analysis extracted 5 common factors, and the cumulative variance contribution rate was 68.811%; the Cronbach's alpha coefficient of the total questionnaire was 0.832, and the re-test reliability was .806; the content validity index of the questionnaire was 0.982, and the content validity index of the items was 0.83-1.00. <i>Conclusion</i>: The construction method of the HHCNQ-DE is scientific and reliable, with good reliability and validity, and it can be used as a tool to measure the needs of home hospice care in mainland China in the future.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"1391-1399"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Impact of the End-of-Life Care Nursing Education Consortium on Knowledge, Attitudes, and Practice (KAP) of Indian Nurses Working in Non-Palliative Care Settings: A KAP-GAP Analysis.","authors":"Mayank Gupta, Gegal Pruthi, Karamjot Singh","doi":"10.1177/10499091231225739","DOIUrl":"10.1177/10499091231225739","url":null,"abstract":"<p><p><b>Background</b>: The End-of-life Care Nursing Education Consortium (ELNEC) program aims to equip nurses with knowledge and skills in palliative and end-of-life care. While this program improves knowledge and attitudes of Indian nurses regarding palliative care and end-of-life care, its long-term impact on their knowledge, attitude, and clinical practice remains unknown. This study aims to assess ELNEC's long-term impact on knowledge, attitude, and practice of Indian nurses. <b>Methods</b>: A 18-month follow-up survey of practicing nurses at a tertiary care institute who completed ELNEC in September 2021. Data was collected between April-June 2023 via a questionnaire covering demographics, Palliative Care Quiz for Nurses (PCQN), Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B) and a clinical practice questionnaire developed and validated to access impact of ELNEC on clinical practice. Quantitative and qualitative data were assessed using Statistical package for social sciences and thematic analysis respectively. The 18-month follow-up PCQN and FATCOD-B scores were compared with the pre-ELNEC (baseline) and immediate post-ELNEC scores. <b>Results</b>: Out of 108 nurses, 69 responded with a response rate of 63.8%. The mean follow-up PCQN score was 9.03 ± 2.58; significantly higher than the pre-ELNEC (8.45 ± 1.88) but lower than the immediate post-ELNEC scores (10.2 ± 1.88). Attitudes toward end-of-life care declined over time but remained positive in the end-of-life care value and care of the dying. Thematic analysis of responses to open questions revealed that ELNEC motivated nurses to work in palliative care and care for patients with chronic life-limiting illnesses (n = 52, 75.3%), improved their nursing practice (n = 60, 86.9%), and helped enhance their communication skills (n = 51, 73.9%). Participants (n = 55, 79.7%) emphasized on regular palliative care training to reinforce their knowledge and skills. <b>Conclusion</b>: Compared with baseline, ELNEC leads to long-term improvement in practicing nurses' palliative care knowledge, clinical practice, communication skills and motivates them to work in palliative care.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"1380-1390"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Patients Requiring Venous Arterial Extracorporeal Membrane Oxygenation: Can Upstream Palliative Care Make a Difference?","authors":"Katie Stevens, Samuel R Anandan, Husneara Rahman, Sima Parikh, An Gao Leung, Andrea Benintendi, Katlynn M Van Ogtrop, Alyssa Stancavage, Christopher J Magalee, Frank Manetta, Christina Saikus, Santiago Lopez","doi":"10.1177/10499091241226606","DOIUrl":"10.1177/10499091241226606","url":null,"abstract":"<p><strong>Objective: </strong>Palliative care consultation is relevant for patients requiring Venous-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO); however, evidence is limited to support its value. For this population, we compared length of stay (LOS) (primary outcome), operational metrics and goals of care (GOC) frequency before and after a collaboration between cardiothoracic (CT) surgery and Geriatrics and Palliative Medicine (GaP).</p><p><strong>Methods: </strong>Retrospective chart review of patients (18+) admitted to a quaternary center that required VA-ECMO between 2019-2021 and received GaP consultation. Demographics, LOS, times to consult, illness severity, GOC, and outcomes were analyzed.</p><p><strong>Results: </strong>120 patients met inclusion criteria and 64 (53.3%) had GaP consultation. No differences were observed regarding demographics and insertion status (emergent vs elective). Median (IQR) days to GaP consult for 2019, 2020 and 2021 were 6.5 (4.0-14.5), 5.0 (2.0-11.0) and 3.0 (2.0-5.0), respectively (<i>P</i> = .006). Median days from insertion to consult for 2019, 2020 and 2021 were 6.0 (4.0-20.0), 3.0 (1.0-6.0) and 2.0 (1.0-4.0) (<i>P</i> = .003). Among survivors, over the 3-year course, median LOS was not statistically different. Between expired patients, median (IQR) LOS for 2019, 2020, and 2021 was 28.5 (23.0-40.0), 12.0 (8.0-14.0), 11.0 (5.0-17.0) days (<i>P</i> = .013). For patients not seen by GaP, 8 (14.3%) GOC notes were documented, compared with 42 (65.6%) for patients seen. Mortality was similar (53.6% vs 53.1% [GaP]).</p><p><strong>Conclusion: </strong>For patient on VA-ECMO, early GaP consultation may improve hospital LOS and GOC rates. We suggest organizations consider early palliative integration when instituting mechanical circulatory support.</p>","PeriodicalId":94222,"journal":{"name":"The American journal of hospice & palliative care","volume":" ","pages":"1431-1441"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}