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

GeriPal

Kate: The problem is we communicate late, we share prognosis late, we elicit goals and values late, so all the time while they’re in the ICU getting prolonged intensive care, we don’t really know that we’re providing goal concordant care, so we wanted to nudge it a little upstream. Eric: Nudge it. Kate: Nudge 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? This is not why I went into emergency medicine. I went into emergency medicine to act. Why is that important in the emergency room?

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

Bernie Lo discloses being an Honorarium Recipient and consultant for Takeda starting on 01/23/2024. Eric: And Laurie for this patient, were you the outpatient provider? I think probably you’ve been hospitalists at some point in your life, you do palliative care consultations. It’s certainly not common in my practice.

Family 112
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Allowing Patients to Die: Louise Aronson and Bill Andereck

GeriPal

So elderly people who aspirated, got pneumonia, had an mi, didn’t get hauled off to the emergency room on an ambulance crew so they could die in the ER. And so I thought about it a while, called, and sure enough, they brought him up to the emergency room. And it’s not the same, but it does provide information.

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Should We Shift from Advance Care Planning to Serious Illness Communication?

GeriPal

And then three weeks later, you’re in the emergency room and somebody else talks with you for a little while. And I think a lot of times when we get consulted, we’re asked for the outcome, right? And I also think, we still operate under pay for… We get paid for the services we provide, right? Eric: Yeah.

Illness 98
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‘Not Accountable to Anyone’: As Insurers Issue Denials, Some Patients Run Out of Options

Physician's Weekly

Prior authorization varies by plan but often requires patients or their providers to get permission (also called precertification, preauthorization, or preapproval) before filling prescriptions, scheduling imaging, surgery, or an inpatient hospital stay, among other expenses. . ” An Unintended Consequence of Health Reform?