Effect of Palliative Care–Led Meetings for Families of Patients With Chronic Critical Illness

Carson, Shannon S.; Cox, Christopher E.; Wallenstein, Sylvan; Hanson, Laura C.; Danis, Marion; Tulsky, James A.; Chai, Emily; Nelson, Judith E.

doi:10.1001/jama.2016.8474

Cited by 289 publications

(273 citation statements)

References 37 publications

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“…This has been termed ''information toxicity.'' 15,16 (2) Prospective measurement of goals as they evolve over time requires time and resources with reflection on what is the right denominator.…”

Section: Measuring Goal Concordancementioning

confidence: 99%

Accountability for Community-Based Programs for the Seriously Ill

Teno

Montgomery

Valuck

et al. 2018

Journal of Palliative Medicine

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Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume-to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person-and family-centered care for persons who are seriously ill.

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Section: Measuring Goal Concordancementioning

confidence: 99%

Accountability for Community-Based Programs for the Seriously Ill

Teno

Montgomery

Valuck

et al. 2018

Journal of Palliative Medicine

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“…It has also been shown that the involvement of families in the decision-making process can create an increased state of post-traumatic stress 3 months after the death, especially when the families received conflicting information or when they felt the decision was not the right one (34). A recent North-American multicentre, randomized, controlled study (35) evaluated the utility of family informational and emotional support meetings led by palliative care clinicians in improving family anxiety and depression. The meeting team consisted of a palliative care physician (except study investigators) and nurse practitioner, and could also include social workers, chaplains, or other disciplines as required.…”

Section: The Specific Situation Of End-of-life Decisionsmentioning

confidence: 99%

What are the ethical issues in relation to the role of the family in intensive care?

Quenot¹,

Ecarnot²,

Meunier-Beillard³

et al. 2017

Ann. Transl. Med.

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“…9 Surrogates' depression and anxiety were not affected by this intervention, but their symptoms of posttraumatic stress were; they went up. This finding highlights a potentially troubling dilemma.…”

Section: Practical Challengesmentioning

confidence: 97%

The Theory and Practice of Surrogate Decision‐Making

Wendler¹

2017

Hastings Center Report

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When a patient lacks decision‐making capacity and has not left a clear advance directive, there is now widespread agreement that patient‐designated and next‐of‐kin surrogates should implement substituted judgment within a process of shared decision‐making. Specifically, after discussing the “best scientific evidence available, as well as the patient's values, goals, and preferences” with the patient's clinicians, the patient‐designated or next‐of‐kin surrogate should attempt to determine what decision the patient would have made in the circumstances. To the extent that this approach works, it seems to provide about as much respect for the autonomy of incapacitated patients as we could ask for. But, as articles in this issue of the Report by Jeffrey Berger and by Ellen Robinson and colleagues emphasize, reality presents challenges.

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Effect of Palliative Care–Led Meetings for Families of Patients With Chronic Critical Illness

Cited by 289 publications

References 37 publications

Accountability for Community-Based Programs for the Seriously Ill

Accountability for Community-Based Programs for the Seriously Ill

What are the ethical issues in relation to the role of the family in intensive care?

The Theory and Practice of Surrogate Decision‐Making

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