The Impact of a Palliative Care Program in a Rural Appalachian Community Hospital: A Quality Improvement Process

被引：7
作者：
Armstrong, Bernita [1 ]
Jenigiri, Bharat [1 ]
Hutson, Sadie P. [2 ]
Wachs, Peter M. [3 ]
Lambe, Camille Eckerd [4 ]
机构：
[1] Pikeville Med Ctr, Pikeville, KY 41501 USA
[2] Univ Tennessee, Coll Nursing, Knoxville, TN USA
[3] Appalachian State Univ, Boone, NC 28608 USA
[4] Duke Univ, Coll Nursing, Durham, NC USA
来源：
AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE | 2013年 / 30卷 / 04期
关键词：
palliative care; palliative care consultation team; end-of-life care; symptom burden; quality of life; cost-effectiveness; OF-LIFE CARE; CONSENSUS RECOMMENDATIONS; FAMILY-MEMBERS; END; OUTCOMES; SATISFACTION; CAREGIVER; EDUCATION; SERVICE; ADULTS;
D O I：
10.1177/1049909112458720
中图分类号：
R19 [保健组织与事业（卫生事业管理）];
学科分类号：
摘要：
Background: Hospital inpatient palliative care consultation services (PCCSs) provide high-quality, comprehensive care for seriously ill patients and their families. The objective of the Palliative Care Impact Study was to evaluate the impact of a PCCS in a rural Appalachian community hospital in 4 domains: clinical, customer, operational, and financial. Methods and Results: A nonrandomized preintervention-postintervention study enrolled 25 patients. We collected data in the 4 domains listed above after a palliative care (PC) consultation and compared them with preconsultation data. Findings demonstrated a statistically significant improvement in pain and symptom burden scores; customer metrics produced an excellent rating of 88.5% by patients and families and physician/providers; with an associated cost savings of $521 per patient per day after PC consultation was complete.
引用
收藏
页码：380 / 387
页数：8
相关论文
共 38 条
[1]   Use of intensive care at the end of life in the United States: An epidemiologic study [J].
Angus, DC ;
Barnato, AE ;
Linde-Zwirble, WT ;
Weissfeld, LA ;
Watson, RS ;
Rickert, T ;
Rubenfeld, GD .
CRITICAL CARE MEDICINE, 2004, 32 (03) :638-643
[2]   Family satisfaction with end-of-life care in seriously ill hospitalized adults [J].
Baker, R ;
Wu, AW ;
Teno, JM ;
Kreling, B ;
Damiano, AM ;
Rubin, HR ;
Roach, MJ ;
Wenger, NS ;
Phillips, RS ;
Desbiens, NA ;
Connors, AF ;
Knaus, W ;
Lynn, J .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2000, 48 (05) :S61-S69
[3]   Methodological challenges in rural and frontier nursing research [J].
Bigbee, Jeri L. ;
Lind, Bonnie .
APPLIED NURSING RESEARCH, 2007, 20 (02) :104-106
[4]   Is there a need for weekend face-to-face inpatient assessments by hospital specialist palliative care services? Evaluation of an out-of-hours service [J].
Birks, Theodore ;
Krikos, Dimitrios ;
McGowan, Catherine ;
Stone, Patrick .
PALLIATIVE MEDICINE, 2011, 25 (03) :278-283
[5]   Increased satisfaction with care and lower costs: Results of a randomized trial of in-home palliative care [J].
Brumley, Richard ;
Enguidanos, Susan ;
Jamison, Paula ;
Seitz, Rae ;
Morgenstern, Nora ;
Saito, Sherry ;
McIlwane, Jan ;
Hillary, Kristine ;
Gonzalez, Jorge .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2007, 55 (07) :993-1000
[6]  
Casarett D, 2011, ARCH INTERN MED, V171, P649, DOI 10.1001/archinternmed.2011.87
[7]   Clinical and Financial Impact of a Palliative Care Program at a Small Rural Hospital [J].
Cassel, J. Brian ;
Webb-Wright, Jennie ;
Holmes, Jim ;
Lyckholm, Laurie ;
Smith, Thomas J. .
JOURNAL OF PALLIATIVE MEDICINE, 2010, 13 (11) :1339-1343
[8]   THE MCGILL QUALITY-OF-LIFE QUESTIONNAIRE - A MEASURE OF QUALITY-OF-LIFE APPROPRIATE FOR PEOPLE WITH ADVANCED DISEASE - A PRELIMINARY-STUDY OF VALIDITY AND ACCEPTABILITY [J].
COHEN, SR ;
MOUNT, BM ;
STROBEL, MG ;
BUI, F .
PALLIATIVE MEDICINE, 1995, 9 (03) :207-219
[9]   The symptom burden of seriously ill hospitalized patients [J].
Desbiens, NA ;
Mueller-Rizner, N ;
Connors, AF ;
Wenger, NS ;
Lynn, J .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 1999, 17 (04) :248-255
[10]  
Dorgan KA, 2009, PREV CHRONIC DIS, V6
1234