Healthcare professionals' perceptions of life-sustaining treatment orders

Perceived Needs Among Healthcare Providers Caring for Seriously Ill Adults Regarding Electronic Health Record Triggers for Palliative Care Referral

“…[1][2][3] The importance of PC service education for healthcare providers is further supported by studies that found healthcare provider comfort level with having serious illness conversations with patients and families and understanding the scope of PC practice have a significant impact on requesting PC consultation. 1,9,12,13,21 One study found that although early PC involvement in the ICU setting was associated with improved patient outcomes, only 50% of patients meeting the trigger criteria were actually referred for PC because of physician resistance. 11 In addition, it was found that based on their personal and professional philosophy about medicine and practice, many physicians often feel that PC referral is a last resort and reserved for the end of life when medical care is futile.…”

“…Several studies support that healthcare providers need to be educated that PC services are not focused solely on end-of-life care, but instead provide a holistic approach to care that addresses complex medical decision-making and symptom management while offering psychological and social support to patients and their families 1–3 . The importance of PC service education for healthcare providers is further supported by studies that found healthcare provider comfort level with having serious illness conversations with patients and families and understanding the scope of PC practice have a significant impact on requesting PC consultation 1,9,12,13,21 . One study found that although early PC involvement in the ICU setting was associated with improved patient outcomes, only 50% of patients meeting the trigger criteria were actually referred for PC because of physician resistance 11 .…”

“…One study found that early PC consultation in the ICU setting was significantly associated with patient status change to DNR (do not resuscitate) hospice referrals leading to earlier hospital discharge, reduced hospital costs, and lower 30-day readmissions; however, only 50% of patients meeting the trigger criteria were actually referred for PC consultation due to physician resistance 11 . Although previous studies have evaluated various types of hospital EHR trigger systems used to identify patients who could benefit from PC referral, few studies exist exploring healthcare provider perceptions regarding the need for EHR PC trigger criteria and what should constitute EHR PC trigger criteria 1,9,12,13 …”

“…11 Although previous studies have evaluated various types of hospital EHR trigger systems used to identify patients who could benefit from PC referral, few studies exist exploring healthcare provider perceptions regarding the need for EHR PC trigger criteria and what should constitute EHR PC trigger criteria. 1,9,12,13…”