Development of a Protocol for Successful Palliative Care Consultation in Population of Patients Receiving Mechanical Circulatory Support

Shilpee Sinha, Carey Belcher, Alexia Torke, Joycelyn Howard, Marco Caccamo, James E. Slaven, Irmina Gradus-Pizlo

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: In 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population. Measures: The goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) before MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation. Intervention: A protocol was developed to conduct interdisciplinary PC consultations for the MCS population. Outcomes: The percentage of PC consults placed before MCS implantation increased from 11 (17.2%) before protocol to 56 (96.6%) after protocol (P < 0.0001) and documented SDM increased from 26 (40.6%) before protocol to 57 (98.3%) after protocol (P < 0.0001). Conclusions: Close PC/cardiology collaboration can substantially improve ACP discussions and SDM documentation in the MCS population. This multidisciplinary protocol facilitates successful PC consultations.

Original languageEnglish (US)
JournalJournal of Pain and Symptom Management
DOIs
StateAccepted/In press - 2017

Fingerprint

Palliative Care
Referral and Consultation
Advance Care Planning
Population
Heart-Assist Devices
Cardiology
Documentation
Joints

Keywords

  • Advance care planning
  • Mechanical circulatory support
  • Palliative care
  • Surrogate decision maker
  • Ventricular assist device

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Development of a Protocol for Successful Palliative Care Consultation in Population of Patients Receiving Mechanical Circulatory Support. / Sinha, Shilpee; Belcher, Carey; Torke, Alexia; Howard, Joycelyn; Caccamo, Marco; Slaven, James E.; Gradus-Pizlo, Irmina.

In: Journal of Pain and Symptom Management, 2017.

Research output: Contribution to journalArticle

@article{ed1fa72934e5474b944f3a3d461d471a,
title = "Development of a Protocol for Successful Palliative Care Consultation in Population of Patients Receiving Mechanical Circulatory Support",
abstract = "Background: In 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population. Measures: The goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) before MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation. Intervention: A protocol was developed to conduct interdisciplinary PC consultations for the MCS population. Outcomes: The percentage of PC consults placed before MCS implantation increased from 11 (17.2{\%}) before protocol to 56 (96.6{\%}) after protocol (P < 0.0001) and documented SDM increased from 26 (40.6{\%}) before protocol to 57 (98.3{\%}) after protocol (P < 0.0001). Conclusions: Close PC/cardiology collaboration can substantially improve ACP discussions and SDM documentation in the MCS population. This multidisciplinary protocol facilitates successful PC consultations.",
keywords = "Advance care planning, Mechanical circulatory support, Palliative care, Surrogate decision maker, Ventricular assist device",
author = "Shilpee Sinha and Carey Belcher and Alexia Torke and Joycelyn Howard and Marco Caccamo and Slaven, {James E.} and Irmina Gradus-Pizlo",
year = "2017",
doi = "10.1016/j.jpainsymman.2017.07.021",
language = "English (US)",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Development of a Protocol for Successful Palliative Care Consultation in Population of Patients Receiving Mechanical Circulatory Support

AU - Sinha, Shilpee

AU - Belcher, Carey

AU - Torke, Alexia

AU - Howard, Joycelyn

AU - Caccamo, Marco

AU - Slaven, James E.

AU - Gradus-Pizlo, Irmina

PY - 2017

Y1 - 2017

N2 - Background: In 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population. Measures: The goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) before MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation. Intervention: A protocol was developed to conduct interdisciplinary PC consultations for the MCS population. Outcomes: The percentage of PC consults placed before MCS implantation increased from 11 (17.2%) before protocol to 56 (96.6%) after protocol (P < 0.0001) and documented SDM increased from 26 (40.6%) before protocol to 57 (98.3%) after protocol (P < 0.0001). Conclusions: Close PC/cardiology collaboration can substantially improve ACP discussions and SDM documentation in the MCS population. This multidisciplinary protocol facilitates successful PC consultations.

AB - Background: In 2014, Joint Commission recommended palliative care (PC) engagement in ventricular assist device (VAD) implantation as destination therapy. Limited information is available on established PC protocols in the mechanical circulatory support (MCS) population. Measures: The goals of our PC consultation were to document advance care planning (ACP) discussions and designate a surrogate decision maker (SDM) before MCS implantation. A retrospective analysis compared the frequency of PC consults, ACP discussion, and SDM before and after protocol implementation. Intervention: A protocol was developed to conduct interdisciplinary PC consultations for the MCS population. Outcomes: The percentage of PC consults placed before MCS implantation increased from 11 (17.2%) before protocol to 56 (96.6%) after protocol (P < 0.0001) and documented SDM increased from 26 (40.6%) before protocol to 57 (98.3%) after protocol (P < 0.0001). Conclusions: Close PC/cardiology collaboration can substantially improve ACP discussions and SDM documentation in the MCS population. This multidisciplinary protocol facilitates successful PC consultations.

KW - Advance care planning

KW - Mechanical circulatory support

KW - Palliative care

KW - Surrogate decision maker

KW - Ventricular assist device

UR - http://www.scopus.com/inward/record.url?scp=85028808998&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028808998&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2017.07.021

DO - 10.1016/j.jpainsymman.2017.07.021

M3 - Article

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

ER -