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Who should get Palliative Care? Kate Courtright

GeriPal

We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. And palliative care was as a program was just growing at Penn moving from just consult hospice to actually having a team when I was training.

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Dementia and high risk surgery: Joel Weissman and Samir Shah

GeriPal

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? And I came to the now I think naive conclusion that fixing and avoiding complications was the secret. They were more likely to have a major inpatient surgical complication. She falls and breaks her hip.

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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

Kate: So it was an embedded alert in the electronic health record and they just clicked those two answers very quickly. It did not change the frequency of palliative care consultation, the timing of such, ICU mortality, or six-month mortality. Eric: And how did you do that? Eric: So how do you put that all together? Kate: Sounds right.

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Artificial Intelligence: Charlotta Lindvall, Matt DeCamp, Sei Lee

GeriPal

Audio: [electronic voice] Alex Smith has been taken over by an artificial intelligence. Because the in serious illness care and care for older adults, their care is often very complex. So there’s some stuff out there like that, but also using AI to determine who at high risk and should get a palliative care consult.

IT 99
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Nudges for Prognosis and Comfort Care in the ICU: Kate Courtright, Scott Halpern, & Jaspal Singh

GeriPal

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center. Where was it?

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RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

GeriPal

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

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Allowing Patients to Die: Louise Aronson and Bill Andereck

GeriPal

You know, she would have had 90 really good years, and she would have just gone into a coma with no blood pressure and died, you know, with, like, a day and a half of illness. Alex 15:13 This is really complicated. And in fact, after a complicated ethics issue, we will oftentimes go in and try and debrief them.