Strategies for whole system change in healthcare (HEARTS in HEALTHCARE)

What is palliative care?

This draft document has been prepared by George Hankins Hull Palliative Care The aim of palliative care is to ease the suffering that results from illness. Palliative care seeks to provide treatment for your symptoms, even when the underlying disease cannot be cured. The goals of palliative care are to relieve your pain and other discomfort and to help reduce your family’s stress. In addition, palliative care seeks to provide information to help you cope and live with a chronic illness. Palliative care encompasses emotional, social, and spiritual needs as well. During the course of your illness, a palliative approach to care can help you and your family to achieve a better quality of life. To request a palliative care consultation You or your family can make a request to consult a palliative care team representative by speaking with your nurse or doctor. Your health care team also may decide to request a palliative care consult. A palliative care representative will visit you within 24...

THE CHAPLAINS' NOTES IN PATIENT CHARTS -- BY RAYMOND J. LAWRENCE A very useful study was reported in the journal Palliative and Supportive Care in May, 2016, entitled "Documenting presence: A descriptive study of chaplain notes in the intensive care unit." The research was completed in September, 2015. The authors of the report were Brittany M. Lee, B.S.; Farr A. Curlin, M.D.; and Philip J. Choi, M.D. The setting of the research was Duke University Hospital, Division of Pulmonary and Critical Care Medicine, in Durham, North Carolina. The study was done with input from the Director of Pastoral Services, Jim Rawlings. The researchers proposed that the recent emphasis on evidence-based practice may be leading chaplains to the use of a reduced, mechanical language insufficient for illuminating patients' individual stories. Whatever the cause may be, it is clear that the chaplains in this study are at sea on the matter of what should be appropriately...

When Palliative Care Begins

Discussion: Sometime ago a New England newspaper, the Worcester Telegram & Gazette, carried a story entitled "Various Pathways Lead to a Good Death." in which a retired former chief of surgery, Dr. H. Brownell, spoke of his concern that too many patients die what he called ‘a bad death.’ In the article Brownell spoke about seeing patients, including his own, die in an intensive care unit with tubes poked into their chests, their bellies and just about every orifice of their bodies. He further commented about patients resuscitated with so much fluid that their faces were unrecognizable, arms black and blue from needles and blood sticks, in severe pain and unable to communicate—and with very little hope of survival. "No one," he commented, "should have to die like this." Janet L. Abrahm, M.D., F.A.C.P., at the University of Pennsylvania School of Medicine, Philadelphia, encourages physicians to broaden their concept of care for patients who are terminal...

Palliative Care Conversations

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