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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. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. It did not change the frequency of palliative care consultation, the timing of such, ICU mortality, or six-month mortality.

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Who should get Palliative Care? Kate Courtright

GeriPal

Palliative care, in contrast, saw explosive growth in US hospitals. 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. I have never myself called a palliative care consult as a trainee because we didn’t have one.

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Storycatching: Podcast with Heather Coats and Thor Ringler

GeriPal

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Every Veteran has a story. Our mission is to help them tell it.

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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. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay.

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Is it time for geriatricians to get on board with lecanemab? Jason Karlawish and Ken Covinsky

GeriPal

Been in the hospital four times, vented, been told the story to her family, she won’t live. Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. So those questions we ask when we’re doing a palliative care consult.

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

GeriPal

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. hospice use). Tammie 02:56 It usually doesn’t work no matter what. So that’s great.

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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

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