Use of an Online Palliative Care Clinical Curriculum to Train U.S. Hospital Staff: 2015–2019

Rogers, Maggie; Chambers, Brittany; Esch, Andrew; Meier, Diane E.; Bowman, Brynn

doi:10.1089/jpm.2020.0514

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…Fifth, the study did not measure primary palliative care provided by other clinicians. Health systems are increasingly supportive of training all clinicians to provide palliative care to promote sustainable palliative care delivery. If primary palliative care delivery occurred less commonly under the intervention than usual care because clinicians more often deferred to specialists, this could have biased comparisons toward the null.…”

Section: Discussionmentioning

confidence: 99%

Default Palliative Care Consultation for Seriously Ill Hospitalized Patients

Courtright,

Madden,

Bayes

et al. 2024

JAMA

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ImportanceIncreasing inpatient palliative care delivery is prioritized, but large-scale, experimental evidence of its effectiveness is lacking.ObjectiveTo determine whether ordering palliative care consultation by default for seriously ill hospitalized patients without requiring greater palliative care staffing increased consultations and improved outcomes.Design, Setting, and ParticipantsA pragmatic, stepped-wedge, cluster randomized trial was conducted among patients 65 years or older with advanced chronic obstructive pulmonary disease, dementia, or kidney failure admitted from March 21, 2016, through November 14, 2018, to 11 US hospitals. Outcome data collection ended on January 31, 2019.InterventionOrdering palliative care consultation by default for eligible patients, while allowing clinicians to opt-out, was compared with usual care, in which clinicians could choose to order palliative care.Main Outcomes and MeasuresThe primary outcome was hospital length of stay, with deaths coded as the longest length of stay, and secondary end points included palliative care consult rate, discharge to hospice, do-not-resuscitate orders, and in-hospital mortality.ResultsOf 34 239 patients enrolled, 24 065 had lengths of stay of at least 72 hours and were included in the primary analytic sample (10 313 in the default order group and 13 752 in the usual care group; 13 338 [55.4%] women; mean age, 77.9 years). A higher percentage of patients in the default order group received palliative care consultation than in the standard care group (43.9% vs 16.6%; adjusted odds ratio [aOR], 5.17 [95% CI, 4.59-5.81]) and received consultation earlier (mean [SD] of 3.4 [2.6] days after admission vs 4.6 [4.8] days; P &lt; .001). Length of stay did not differ between the default order and usual care groups (percent difference in median length of stay, −0.53% [95% CI, −3.51% to 2.53%]). Patients in the default order group had higher rates of do-not-resuscitate orders at discharge (aOR, 1.40 [95% CI, 1.21-1.63]) and discharge to hospice (aOR, 1.30 [95% CI, 1.07-1.57]) than the usual care group, and similar in-hospital mortality (4.7% vs 4.2%; aOR, 0.86 [95% CI, 0.68-1.08]).Conclusions and RelevanceDefault palliative care consult orders did not reduce length of stay for older, hospitalized patients with advanced chronic illnesses, but did improve the rate and timing of consultation and some end-of-life care processes.Trial RegistrationClinicalTrials.gov Identifier: NCT02505035

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Section: Discussionmentioning

confidence: 99%

Default Palliative Care Consultation for Seriously Ill Hospitalized Patients

Courtright,

Madden,

Bayes

et al. 2024

JAMA

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“…While delivering hospice and palliative care education in an online environment is not a novel finding in the literature, [7][8][9][10][11] combining synchronous online education with virtual patient encounters is not well investigated. During the 2020 IPC Seminar, a variety of secure virtual platforms were used so students could engage in discussions with patients while maintaining safety to prevent exposure of patients and students to a potentially deadly virus.…”

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confidence: 99%

Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar

Mollman

Gierach

2023

Am J Hosp Palliat Care

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Background The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform. Methods To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students’ clinical experiences and practice. Results The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients. Discussion Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. Conclusion Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.

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Use of an Online Palliative Care Clinical Curriculum to Train U.S. Hospital Staff: 2015–2019

Cited by 2 publications

References 16 publications

Default Palliative Care Consultation for Seriously Ill Hospitalized Patients

Default Palliative Care Consultation for Seriously Ill Hospitalized Patients

Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar

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