Journal Club

the precarious nature of the team when challenges are faced …

Hospice & Palliative Medicine, Journal Club /

Swetenham et al and Hegarty etal study the impact of refractory suffering on the interdisciplinary team. “Refractory suffering – that is, suffering that persists unrelieved despite all attempts by an interdisciplinary team to ameliorate it, is one of the most difficult and challenging aspects of palliative care practice. Its effects on clinicians have been documented. […]

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humility … and teamwork … pit crews for patients

Hospice & Palliative Medicine, Journal Club, KU Med School /

Gawande identifies core values for today’s physicians … “Which brings us to the third skill that you must have but haven’t been taught—the ability to implement at scale, the ability to get colleagues along the entire chain of care functioning like pit crews for patients. There is resistance, sometimes vehement resistance, to the efforts that

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cherry picking …

Hospice & Palliative Medicine, Journal Club /

… Charles von Gunten’s comments on the recent JAMA article looking at non-profit & for profit hospice characteristics. “The for-profit agencies whose shares are traded publicly on the stock exchanges and report large profits do, in fact, ‘‘cherry pick’’ less expensive patients who live longer … Now that the data are out—everyone in the United States should

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aligning treatment with patient needs …

Hospice & Palliative Medicine, Journal Club /

Palliative care focuses on improving a patient’s quality of life by managing pain and other distressing symptoms of a serious illness. Palliative care should be provided along with other medical treatments. Hospice is palliative care for patients in their last year of life. Hospice care can be provided in patients’ homes, hospice centers, hospitals, longterm

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it’s not just what the doctor tells me …

Bioethics, Hospice & Palliative Medicine, Journal Club /

… factors that influence decision makers’ perceptions of prognosis … Boyd et al sought to determine what sources of knowledge family members/decision makers use when determining the prognosis of their loved ones. “Less than 2% (3 of 179) of surrogates reported that their beliefs about the patients’ prognoses hinged exclusively on prognostic information provided to

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core aspects of family conferences …

Hospice & Palliative Medicine, Journal Club /

… Fineberg etal present an empirically derived model of family conferences. Core aspects include conference organization, negotiation, personal stance and emotional work … all working toward meaningful connections with those involved. “Emotion work during the family conference appears to function as a crucial gatekeeper to achieving the desired outcome for the meeting.” Fineberg etal. Communication with Families

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