Palliative Educational Outcome with Implementation of PEACE Tool Integrated Clinical Pathway

Abstract

A time-effective, practice-based strategy led to a significant improvement in knowledge of end-of-life care. Prior to implementation of this strategy competency in end-of-life care was suboptimal among internal medicine residents, in spite of desirable attitudes. Factual knowledge improved slightly with standard, pre-intervention training and experience.

Using a Pocket Card to Improve End-of-life Care on Internal Medicine Clinical Teaching Units: A Cluster-randomized Controlled Trial

“…The total number of residents participating was more than double that of similar studies of pocket references in the literature. 13,14 More than 90% of residents in the intervention group reported using the card at least once a week. Although participants may have been affected by reporting bias, we feel that this number confirms our hypothesis that a brief, portable, and practical card would be attractive to residents.…”

“…Okon et al provided trainees with a lengthy pocket manual as part of a comprehensive curriculum on a dedicated palliative care rotation. 13 Critchley et al used a more concise card, but it was studied primarily using clinicians already in practice, and only using self-reported measures of efficacy. 14 In the present study, we sought to investigate the utility of a portable, concise pocket card for improving knowledge and comfort with end-of-life care among residents on a medical CTU.…”

The Growth of Palliative Care in the United States

“…A recent study shows that if the primary care physician remains involved, patient and family have less distress (5). Educational programs have been successful in teaching physicians, in training and in practice, important knowledge and communication skills used in palliative care (3,6,30,31,80,89), but much more needs to be done to deliver primary palliative care across the health care system. Variation exists with regard to physician willingness to refer patients to a secondary palliative care specialist or team (1,99).…”

Palliative Care for Nephropathic Patients

“…15 The quality of care given to the patients may be evaluated through the PEACE score: a simple tool addressing six domains on physical, emotive, autonomy-related symptoms; communication and completion of life issues; economic burden and religious beliefs. 24 However, although this tool may be of help for clinicians, the most important factor to consider when making a clinical decision is the autonomy of the patient who faces ESRD and of the relatives who provide support. 15 In particular, Parlevliet et al showed that caregivers are often forced to change their routine and professional schedules, and 84% of them feel overburdened by the situation.…”