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

3 Scopus citations

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)
Pages (from-to)583-588
Number of pages6
JournalJournal of Pain and Symptom Management
Volume54
Issue number4
DOIs
StatePublished - Oct 2017

Keywords

  • Palliative care
  • advance care planning
  • mechanical circulatory support
  • surrogate decision maker
  • ventricular assist device

ASJC Scopus subject areas

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

Fingerprint Dive into the research topics of 'Development of a Protocol for Successful Palliative Care Consultation in Population of Patients Receiving Mechanical Circulatory Support'. Together they form a unique fingerprint.

  • Cite this