{"id":250,"date":"2017-05-01T18:03:33","date_gmt":"2017-05-01T22:03:33","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-mhcdsolutions\/submission\/end-of-life-care\/"},"modified":"2017-05-01T18:03:33","modified_gmt":"2017-05-01T22:03:33","slug":"end-of-life-care","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/submission\/end-of-life-care\/","title":{"rendered":"End of Life Care"},"content":{"rendered":"<p>At our Institute, one of the biggest changes we&#8217;ve made in the past three years has been strengthening our palliative care team to support our patients. \u00a0\u00a0While the team has been adopted nicely into the larger Institute, issues remain regarding timely referrals and even referrals at all from resistant services.\u00a0 Too often an inpatient is referred to the program at the very end of life or after an extended time spent in the ICU.\u00a0 Further downstream, hospice usage and Length of Stay also suffer due to this delayed response.\u00a0 In addition, the capture of Advanced Directives and DNR orders are lacking as well.<\/p>\n<p>Common responses and push back to the utilization of Palliative care is believing that the home service is actually providing the service, or doesn\u2019t want to give up on the patient.<\/p>\n<p>The team is working on a trigger to increase referrals, with MD\u2019s being prompted with the question, \u201cWould you be surprised if the patient were to die within a year?\u201d.\u00a0 In the event that they say \u201cNo\u201d, the MD would be forced to state \u201cyes\u201d or \u201cno\u201d as to whether or not the patient is being referred.<\/p>\n<p>I\u2019m curious with the experience on this board.\u00a0 What are the successes that you\u2019ve had in integrating Palliative Care in your systems?\u00a0 Do you have any other way to trigger referrals?\u00a0 Any great successes in improving end of life care (Advanced Directives, Hospice Utilization, etc)?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Strategies to improve Palliative Care adoption and end of life care.<\/p>\n","protected":false},"author":9186,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","categories":[],"class_list":["post-250","hck-submission","type-hck-submission","status-publish","hentry"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-mhcdsolutions\/conversation\/mhcd-solutions-ii\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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