Harnessing the Chaplain’s Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department-Reference-Cited by-同舟云学术

Harnessing the Chaplain’s Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department

Published:2021-04-05 Issue: Volume: Page:082585972110033
ISSN:0825-8597
Container-title:Journal of Palliative Care
language:en
Short-container-title:J Palliat Care

Author:

Hamill Howard Elizabeth¹^ORCID,Schwartz Rachel²,Feldstein Bruce¹³⁴,Grudzen Marita⁵,Klein Lori¹,Piderman Katherine M.⁶⁷^ORCID,Wang David⁸

Affiliation:

1. Spiritual Care Service, Stanford Health Care, Stanford, CA, USA

2. WellMD Center, Stanford University School of Medicine, Stanford, CA, USA

3. Department of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA

4. Jewish Chaplaincy Services serving Stanford Medicine, a program of Jewish Family & Children’s Services of San Francisco, the Peninsula, Marin and Sonoma Counties, CA, USA

5. Stanford Geriatric Education Center, Stanford University School of Medicine, Stanford, CA, USA

6. Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA

7. Transforming Chaplaincy, Chicago, IL, USA

8. Palliative Medicine, Scripps Health, San Diego, CA, USA

Abstract

Objective: To explore chaplains’ ability to identify unmet palliative care (PC) needs in older emergency department (ED) patients. Methods: A palliative chaplain-fellow conducted a retrospective chart review evaluating 580 ED patients, age ≥80 using the Palliative Care and Rapid Emergency Screening (P-CaRES) tool. An emergency medicine physician and chaplain-fellow screened 10% of these charts to provide a clinical assessment. One year post-study, charts were re-examined to identify which patients received PC consultation (PCC) or died, providing an objective metric for comparing predicted needs with services received. Results: Within one year of ED presentation, 31% of the patient sub-sample received PCC; 17% died. Forty percent of deceased patients did not receive PCC. Of this 40%, chaplain screening for P-CaRES eligibility correctly identified 75% of the deceased as needing PCC. Conclusion: Establishing chaplain-led PC screenings as standard practice in the ED setting may improve end-of-life care for older patients.

Funder

The Clinical Pastoral Education program of Stanford Health Care

Publisher

SAGE Publications

Subject

General Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/08258597211003359

Reference25 articles.

1. Beyond Code Status: Palliative Care Begins in the Emergency Department

2. Emergency Care Use and the Medicare Hospice Benefit for Individuals with Cancer with a Poor Prognosis

3. Half Of Older Americans Seen In Emergency Department In Last Month Of Life; Most Admitted To Hospital, And Many Die There

4. Emergency Department-Based Palliative Care during COVID

5. Emergency Department–Initiated Palliative Care in Advanced Cancer

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1. A comparison of palliative care and rapid emergency screening (P-CaRES) tool, broad and narrow criteria, and surprise questions to predict survival of older emergency department patients;BMC Palliative Care;2023-06-27

2. Screening tools to identify patients with unmet palliative care needs in the emergency department: A systematic review;Academic Emergency Medicine;2022-06-14