ROCHESTER Group END-OF-LIFE Study REPORT January 2001.


89 views
Uploaded on:
Category: Fashion / Beauty
Description
ROCHESTER Group END-OF-LIFE Overview REPORT January 2001 RIPA/BLUE CROSS END-OF-LIFE/PALLIATIVE Consideration Proficient Counseling Board Individuals from the RIPA/BCBSRA Proficient Consultative Panel Howard Beckman , M.D., Medicinal Chief, RIPA, Advisory group Seat
Transcripts
Slide 1

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 RIPA/BLUE CROSS END-OF-LIFE/PALLIATIVE CARE PROFESSIONAL ADVISORY COMMITTEE

Slide 2

Members of the RIPA/BCBSRA Professional Advisory Committee Howard Beckman , M.D., Medical Director, RIPA, Committee Chair  Judith Gedney Baggs , Ph.D., R.N., Associate Professor University of Rochester School of Nursing and School of Medicine and Dentistry Edgar Black , M.D., Chief Medical Officer, BCBSRA Patricia Bomba , M.D., Excellus Medical Director, Geriatrics, Patricia Heffernan , C.S.W., VP, Genesee Region Home Care Robert McCann , M.D., Chief, Department of Medicine, Highland Hospital Kathy McGrail , M.D., Medical Director, VNS Hospice Nancy Pictor , RN, RIPA Special Project Staff Timothy Quill , M.D., Director of Program for Bio-Pyschosocial Studies at the University of Rochester Bernard Shore , M.D., Medical Director, Jewish Home of Rochester Julia Smith , M.D., Oncologist and Director, Palliative Care Unit, Genesee Hospital Rocco Vivenzio , M.D., Geriatrician and Board part, RIPA.

Slide 3

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001

Slide 4

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Are Advance Directives requested on admission to your office? Provided that this is true, what rate of patients had advance mandates in their records?

Slide 5

ADVANCE CARE DIRECTIVES IN RECORD

Slide 6

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 What percent of inhabitants/customers/patients have living wills, tough force of lawyer, DNR requests, or human services intermediary?

Slide 7

TYPE OF ADVANCE CARE DIRECTIVE COMPLETED

Slide 8

ADVANCE CARE DIRECTIVES SKILLED NURSING FACILITIES

Slide 9

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 What rate of patients with malignancy, heart disappointment, COPD/emphysema or dementia has an Advance Directive or a DNR request set up? (Home Care and Hospice just)

Slide 10

ADVANCE CARE DIRECTIVES HOME CARE PATIENTS CHRONIC ILLNESS

Slide 11

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Do your ailment administration pathways for growth, heart disappointment, COPD/emphysema and dementia incorporate an examination of development consideration arranging?

Slide 12

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Is agony recorded as an essential sign by medical attendants/associates in your establishment?

Slide 13

PAIN AS 5TH VITAL SIGN

Slide 14

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 What percent of hospice patients bite the dust inside of 7 days of referral to the project?

Slide 15

HOSPICE PATIENTS DIED WITHIN 7 DAYS OF REFERRAL

Slide 16

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 What is the normal length of stay for hospice patients alluded from clinics, home care, doctor’s workplaces, and gifted nursing offices?

Slide 17

AVERAGE LOS HOSPICE PATIENTS BASED ON REFERRAL SITE

Slide 18

PATIENTS ENROLLED IN HOSPICE BY DIAGNOSIS

Slide 19

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 What percent of opioid solutions are for long acting arrangements?

Slide 20

Qualitative Assessment of Comments from SNF’s Communication in the middle of staff and occupants/families is tedious and troublesome. Numerous occupants and families don\'t comprehend Advance Directives. Numerous inhabitants and families deny the need to settle on end-of-life choices. The absence of dialog between an inhabitant and his/her intermediary brought about clashes for consideration suppliers with respect to the resident’s communicated wishes and those of the assigned intermediary. Clarity between occupant, family, intermediary, and staff results in taking after resident’s wishes, which increments staff’s proficient fulfillment.

Slide 21

Questions for Group & Experts What ought to our benchmark be for % of patients admitted to an office with an AD? What exhaustive AD structures are accessible? In what capacity would we be able to receive a group standard and guarantee all will acknowledge it? What are sensible benchmarks for the % of patients who bite the dust inside of 7 days of referral to hospice?

Slide 22

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Areas most needing consideration

Slide 23

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Assuring that a more prominent rate of patients, particularly patients with incessant incapacitating ailments, comprehend, finish, and utilization Advance Directives. Once finished, social insurance establishments must guarantee their accessibility and focus on regarding them.

Slide 24

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Promoting prior hospice referrals for critically ill patients so that the social, otherworldly, and mental parts of affliction can be tended to.

Slide 25

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Establishing complete agony appraisal and treatment norms at all offices and organizations.

Slide 26

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Encouraging human services organizations to set execution objectives and track essential insights in regards to end-of-life consideration

Slide 27

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Specific Recommendations

Slide 28

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Advance Directives Offer various expert and lay presentations on Advance Directives. Advance general acknowledgment of an Advance Directive structure, which, once finished, would be respected at all group offices. Set up group norms and fundamental measures that ought to be followed at all medicinal services organizations.

Slide 29

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Advance Directives (proceeded with) Share asset materials that help with the talk of Advance Directives. Prescribe Advance Care Directives prompts on all Rochester Health Commission rules and site-particular ceaseless sickness pathways. Clear up, then teach essential think doctors about repayment alternatives for talking about Advance Directives with patients.

Slide 30

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Hospice Referrals Educate experts and caseworkers with respect to side effect pointers in endless ailment that foresee a six-month or less anticipation. Suggest consideration of hospice referral prompts as suitable in illness administration and home care organization pathways.

Slide 31

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Hospice Referrals (proceeded with) Encourage prior referrals to hospice, in this way diminishing the rate of patients kicking the bucket inside of seven days of admission to hospice. Give input to offices with respect to hospice referral examples on a quarterly premise (clinics, home care offices, talented nursing offices, and doctor associations).

Slide 32

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Evaluation and Management of Pain & Other Symptoms Recommend principles for routine torment appraisal and administration for all offices. Circulate cases of “best practice” strategies. Report opioid use designs per ailment for the Rochester Community.

Slide 33

ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Establish a system of repayment for affirmed palliative consideration pros to give counsels at all range healing centers, hospice projects, home care offices, and talented nursing offices by 6/30/01. .:ts

Recommended
View more...