Remote Advance Care Planning in the Emergency Department During COVID-19 Disaster : Program Development and Initial Evaluation
Copyright © 2021. Published by Elsevier Inc..
BACKGROUND: The coronavirus disease 2019 pandemic caused an unprecedented surge of patients presenting to emergency departments and forced hospitals to adapt to provide care to patients safely and effectively. The purpose here was to disseminate a novel program developed under disaster conditions to address advance care planning communications.
METHODS: A program development and initial evaluation was conducted for the Remote Goals of Care program, which was created for families to communicate patient goals of care and reduce responsibilities of those in the emergency department.
RESULTS: This program facilitated 64 remote goals of care conversation, with 72% of conversations taking place remotely with families of patients who were unable to participate. These conversations included discussions of patient preferences for care, including code status, presence of caregivers or surrogates, understanding of diagnosis and prognosis, and hospice care. Initially, this program was available 24 hours per day, 7 days per week, with gradual reduction in hours as needs shifted. Seven nurses who were unable to work in corona-positive environments but were able to continue working remotely were utilized. Lessons learned include the need for speed and agility of response and the benefit of established relationships between traditionally siloed specialties. Additional considerations include available technology for patients and families and expanding the documentation abilities for remote nurses. A logic model was developed to support potential program replication at other sites.
DISCUSSION: Upon initial evaluation, Remote Goals of Care Program was well received and demonstrated promise in decanting the responsibility of goals of care discussions from the emergency department to a calmer, remote setting. In future iterations, additional services and technology adjustments can be made to make this program more accessible to more patients and families. Other facilities may wish to replicate our Remote Goals of Care Program described here.
| Errataetall: |
CommentIn: J Emerg Nurs. 2022 Jan;48(1):7-9. - PMID 34996574 |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
|---|---|
| Enthalten in: |
Journal of emergency nursing - 48(2022), 1 vom: 19. Jan., Seite 22-31 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Liberman, Tara [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Advance care planning |
|---|
| Anmerkungen: |
Date Completed 11.01.2022 Date Revised 13.01.2022 published: Print-Electronic CommentIn: J Emerg Nurs. 2022 Jan;48(1):7-9. - PMID 34996574 Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.jen.2021.09.006 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM331904527 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM331904527 | ||
| 003 | DE-627 | ||
| 005 | 20231225214511.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.jen.2021.09.006 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1106.xml |
| 035 | |a (DE-627)NLM331904527 | ||
| 035 | |a (NLM)34649729 | ||
| 035 | |a (PII)S0099-1767(21)00252-X | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Liberman, Tara |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Remote Advance Care Planning in the Emergency Department During COVID-19 Disaster |b Program Development and Initial Evaluation |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 11.01.2022 | ||
| 500 | |a Date Revised 13.01.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: J Emerg Nurs. 2022 Jan;48(1):7-9. - PMID 34996574 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021. Published by Elsevier Inc. | ||
| 520 | |a BACKGROUND: The coronavirus disease 2019 pandemic caused an unprecedented surge of patients presenting to emergency departments and forced hospitals to adapt to provide care to patients safely and effectively. The purpose here was to disseminate a novel program developed under disaster conditions to address advance care planning communications | ||
| 520 | |a METHODS: A program development and initial evaluation was conducted for the Remote Goals of Care program, which was created for families to communicate patient goals of care and reduce responsibilities of those in the emergency department | ||
| 520 | |a RESULTS: This program facilitated 64 remote goals of care conversation, with 72% of conversations taking place remotely with families of patients who were unable to participate. These conversations included discussions of patient preferences for care, including code status, presence of caregivers or surrogates, understanding of diagnosis and prognosis, and hospice care. Initially, this program was available 24 hours per day, 7 days per week, with gradual reduction in hours as needs shifted. Seven nurses who were unable to work in corona-positive environments but were able to continue working remotely were utilized. Lessons learned include the need for speed and agility of response and the benefit of established relationships between traditionally siloed specialties. Additional considerations include available technology for patients and families and expanding the documentation abilities for remote nurses. A logic model was developed to support potential program replication at other sites | ||
| 520 | |a DISCUSSION: Upon initial evaluation, Remote Goals of Care Program was well received and demonstrated promise in decanting the responsibility of goals of care discussions from the emergency department to a calmer, remote setting. In future iterations, additional services and technology adjustments can be made to make this program more accessible to more patients and families. Other facilities may wish to replicate our Remote Goals of Care Program described here | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Advance care planning | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Emergency department | |
| 650 | 4 | |a Goals of care | |
| 650 | 4 | |a Telehealth | |
| 700 | 1 | |a Roofeh, Regina |e verfasserin |4 aut | |
| 700 | 1 | |a Chin, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Chin, Kelly |e verfasserin |4 aut | |
| 700 | 1 | |a Razack, Bibi |e verfasserin |4 aut | |
| 700 | 1 | |a Aquilino, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Herod, Sarah Healey |e verfasserin |4 aut | |
| 700 | 1 | |a Amato, Teresa |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of emergency nursing |d 1993 |g 48(2022), 1 vom: 19. Jan., Seite 22-31 |w (DE-627)NLM000325791 |x 1527-2966 |7 nnns |
| 773 | 1 | 8 | |g volume:48 |g year:2022 |g number:1 |g day:19 |g month:01 |g pages:22-31 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.jen.2021.09.006 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 48 |j 2022 |e 1 |b 19 |c 01 |h 22-31 | ||