Breaking News
March 22, 2019 - Servier collaborates with Harvard researchers to fight metabolic diseases
March 22, 2019 - National Eating Disorders Association
March 22, 2019 - Pumping up red blood cell production
March 22, 2019 - Excessive phosphate fertilizer may hurt plants by altering microbial composition in soil
March 22, 2019 - Medical marijuana laws could be improving older Americans’ health, study suggests
March 22, 2019 - Study indicates the benefits of stopping aspirin in heart attack patients
March 22, 2019 - Deep brain stimulation offers significant relief for patients with treatment-resistant depression
March 22, 2019 - Mental health problems in young adults on the rise
March 22, 2019 - Innovative membrane offers a viable solution for periodontitis
March 22, 2019 - The FDA Grants Rare Pediatric Disease Designation to Odiparcil for the Treatment of MPS VI
March 22, 2019 - insulin therapy: MedlinePlus Medical Encyclopedia
March 22, 2019 - Guidelines on the use of genetic testing in psychiatry
March 22, 2019 - Aspiring Doctors Seek Advanced Training In Addiction Medicine
March 22, 2019 - A change in focus could enable the development of new treatments for Alzheimer’s disease
March 22, 2019 - A new way to visualize the immune cell “landscape” of bowel cancer tumors
March 22, 2019 - Understanding maintenance of quiescent stem cells in chronic myelogenous leukemia
March 22, 2019 - Ludwig scientists to share advances in cancer research at AACR Annual Meeting 2019
March 22, 2019 - Less invasive valve replacement can be safe and effective alternative for healthier patients
March 22, 2019 - Aphasia research reveals new, complex interactions between thought and language
March 22, 2019 - Artificial neural networks can predict how different areas in the brain respond to words
March 22, 2019 - Age-related changes to gut microbiome have adverse impact on vascular health, study shows
March 22, 2019 - Isolated seniors chat online to prevent cognitive decline
March 22, 2019 - Naltrexone implant more effective in reducing relapses in HIV patients with opioid addiction
March 22, 2019 - The Brain Institute wins $7.04 million grant to investigate ‘neurophilosphy of free will’
March 22, 2019 - Karyopharm Announces FDA Extension of Review Period for Selinexor New Drug Application
March 22, 2019 - Eruptive xanthomatosis
March 22, 2019 - Cause of vascular disease in kidney failure reversed in animal model
March 22, 2019 - Researchers discover possible new therapeutic strategy for pancreatic cancer
March 22, 2019 - Ebola spreads to second largest city in DRC
March 22, 2019 - Perivascular spaces contribute to worse cognitive health in older adults
March 22, 2019 - Adolescent daily users more likely to obtain electronic cigarettes from commercial sources
March 22, 2019 - FDA Approves Genentech’s Tecentriq in Combination With Chemotherapy for the Initial Treatment of Adults With Extensive-Stage Small Cell Lung Cancer
March 22, 2019 - Diabetes myths and facts: MedlinePlus Medical Encyclopedia
March 22, 2019 - TGen and ABL pursue global rollout of advanced TB test
March 22, 2019 - Traffic light labels influence people to choose healthier and more sustainable meals
March 22, 2019 - Alzheimer’s patients using antiepileptic drugs have twice the risk of pneumonia, study shows
March 22, 2019 - Skin diseases may be more prevalent than previously thought
March 22, 2019 - Overall rates of death from breast cancer are falling across the EU
March 22, 2019 - Novel plasmid could hold key to control of mosquito-borne illness
March 22, 2019 - Female Emergency Physicians Paid Less Than Males
March 22, 2019 - Estimated average glucose (eAG): MedlinePlus Medical Encyclopedia
March 22, 2019 - Experimental drug could be new option for type 2 diabetes
March 22, 2019 - Five Things To Know About The Electronic Health Records Mess
March 22, 2019 - TMJ disorders could be treated with tissue-engineered implants after successful animal study
March 22, 2019 - Team-based approach is key to successful care of pregnant women with heart failure
March 22, 2019 - Study identifies gene variant associated with accelerated cellular aging
March 21, 2019 - Salk scientists show how background noise from neurons can interrupt focused attention
March 21, 2019 - New class of drugs could help treat patients diagnosed with ovarian cancer
March 21, 2019 - Tecentriq Approved for Small Cell Lung Cancer
March 21, 2019 - Adipocyte glucocorticoid receptors play a role in developing steroid diabetes
March 21, 2019 - Climate change can affect nutrient content of crops, harming human health
March 21, 2019 - Podcast: KHN’s ‘What The Health’ Surprise! Fixing Surprise Medical Bills Is Harder Than it Looks
March 21, 2019 - Chemistry researchers patent new method for making anti-leukemia compounds
March 21, 2019 - UIC scientists identify hidden proteins in bacteria
March 21, 2019 - New Australian drug trial achieves remarkable results in patients with acute myeloid leukemia
March 21, 2019 - Females live longer when they have help raising offspring
March 21, 2019 - How did orthodontists sell orthodontics?
March 21, 2019 - In the Spotlight: From dietitian to physician assistant student
March 21, 2019 - The CRISPR Revolution: What You Need to Know
March 21, 2019 - FDA Chief Calls For Stricter Scrutiny Of Electronic Health Records
March 21, 2019 - Combined glucocorticoid and antioxidant therapy could benefit premature babies
March 21, 2019 - Low levels of certain eye proteins could serve as predictor for Alzheimer’s
March 21, 2019 - Post-traumatic holocaust survivors transmit negative views on aging to offspring
March 21, 2019 - City of Hope receives $7.5 million in grant awards to study cutaneous T cell lymphoma
March 21, 2019 - New video game-led training device helps stroke survivors regain arm mobility
March 21, 2019 - Compounds in coffee could slow prostate cancer growth
March 21, 2019 - New mobile DNA element in Wolbachia may contribute to improved disease control strategies
March 21, 2019 - Phase 2 Clinical Trial of Bermekimab Shows Potential New Standard of Care for Treatment of Hidradenitis Suppurativa, Including Significant Pain Reduction without Antibiotics
March 21, 2019 - More than one-third of patients risk major bleeding by doubling up on blood thinners
March 21, 2019 - A skeptical look at popular diets: Thumbs up for Mediterranean
March 21, 2019 - PTSD After Cardiac Arrest Predicts More Heart Trouble
March 21, 2019 - Role of immunological imprinting in elicitation of new antibodies
March 21, 2019 - Breast cancer relapse predictor tool may soon be a reality
March 21, 2019 - New computer program developed by TGen lights up cancer-causing genetic mutations
March 21, 2019 - FDA warns two breast implant makers for failure to comply with post-approval study requirements
March 21, 2019 - Butler Hospital receives COBRE grant to enhance research on neuropsychiatric illnesses
March 21, 2019 - Majority of osteoporosis clinical practice guidelines ignore patients’ voices
March 21, 2019 - Generic messages don’t help patients to lose weight
March 21, 2019 - Eisai and Imbrium Therapeutics Announce U.S. FDA Filing Acceptance of New Drug Application for Lemborexant for the Treatment of Insomnia
March 21, 2019 - Two-drug combos using popular calcium channel blocker show superiority in lowering BP
New family support program improves patient-centered care and lowers hospitalization costs

New family support program improves patient-centered care and lowers hospitalization costs

image_pdfDownload PDFimage_print

Families of critically ill hospital patients report higher satisfaction with clinician communication and a better perception of patient-centered care when the care team uses a low-cost strategy involving intensive emotional support and frequent meetings, according to the results of a University of Pittsburgh School of Medicine randomized trial being presented today at the ATS 2018 International Conference in San Diego and scheduled for publication in the June 21 issue of the New England Journal of Medicine.

The program – known as PARTNER (PAiring Re-engineered ICU Teams with Nurse-driven Emotional Support and Relationship-building) – also reduced patients’ lengths of stay in intensive care units (ICUs) and lowered hospitalization costs. During the trial, the program cost an average of $170 per patient, but it reduced hospitalization costs by 28 percent.

“One in five Americans die in or shortly after discharge from an ICU – typically when a loved one decides to forego life-prolonging therapies. That difficult decision can be made unnecessarily stressful when there are problems with communication between a patient’s family and their care team,” said Douglas B. White, M.D., M.A.S., director of the Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center’s Program on Ethics and Decision Making in Pitt’s Department of Critical Care Medicine. “PARTNER helps the clinical team establish relationships and provide support to the family well before decisions have to be made about goals of care.”

PARTNER is delivered by the interprofessional team in the ICU, consisting of nurses, physicians, spiritual care providers, social workers and others who play a part in patient care. The program is overseen by nurse-leaders in each ICU who receive 12 hours of advanced communication skills training to support families. The nurses meet with the families daily and arrange interdisciplinary clinician-family meetings within 48 hours of a patient coming to the ICU. A quality improvement specialist helps to incorporate the family support intervention into the clinicians’ workflow.

To test its effectiveness, PARTNER was rolled out at five UPMC ICUs with different patient populations and staffing. It was implemented in a staggered fashion so that every participating ICU would eventually get PARTNER. Before receiving PARTNER, the ICUs continued their usual methods of supporting families of hospitalized patients. None of the ICUs had a set approach to family communication or required family meetings at regular intervals before receiving PARTNER.

A total of 1,420 adult patients were enrolled in the trial, and 1,106 of these patients’ family members agreed to be a part of the study and its six-month follow-up surveys. The patients were very sick, with about 60 percent dying within six months of hospitalization and less than 1 percent living independently at home at that point.

Families who participated in the intervention were more likely to report that their loved one received patient-centered care – where the patient’s comfort, emotional well-being, beliefs and cultural needs were respected and guided clinical actions. Of those receiving PARTNER, 79.2 percent scored their loved one’s care in the highest patient-centeredness category on an assessment, compared to 63.2 percent of those who received usual care.

The intervention cut the average hospital length-of-stay by more than three days, from 13.5 to 10.4 days, and shortened the average time patients spent in the ICU from 7.4 to 6.7 days.

“We also observed a slightly higher rate of in-hospital mortality, which came with families reporting more patient-centered care and better communication,” said White, who also holds the UPMC Chair for Ethics in Critical Care Medicine. “This was likely because the intervention supported families in determining what goals of care were most respectful to the patient as a person in the setting of very advanced illness.” ​​​​

Source:

http://www.ccm.pitt.edu/news/team-approach-support-families-improves-icu-patient-centered-care-and-lowers-costs

Tagged with:

About author

Related Articles