ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 RIPA/BLUE CROSS END-OF-LIFE/PALLIATIVE CARE PROFESSIONAL ADVISORY COMMITTEESlide 2
Members of the RIPA/BCBSRA Professional Advisory Committee Howard Beckman , M.D., Medical Director, RIPA, Committee Chair Â 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 2001Slide 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 RECORDSlide 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 COMPLETEDSlide 8
ADVANCE CARE DIRECTIVES SKILLED NURSING FACILITIESSlide 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 ILLNESSSlide 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 SIGNSlide 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 REFERRALSlide 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, doctorâs workplaces, and gifted nursing offices?Slide 17
AVERAGE LOS HOSPICE PATIENTS BASED ON REFERRAL SITESlide 18
PATIENTS ENROLLED IN HOSPICE BY DIAGNOSISSlide 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 SNFâs 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 residentâs communicated wishes and those of the assigned intermediary. Clarity between occupant, family, intermediary, and staff results in taking after residentâs wishes, which increments staffâs 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 considerationSlide 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 considerationSlide 27
ROCHESTER COMMUNITY END-OF-LIFE SURVEY REPORT January 2001 Specific RecommendationsSlide 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 âbest practiceâ 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
Rustic Group TRANSPORT Study Examination of Study Discoveries. Inverness and Nairn Transport Gat ...
Atmosphere for Minorities at UK An Outline of Different Overview Discoveries (1997 – 2001) Rev ...
Changes in water temperature and predators are the greatest danger to the eggs. ... Did you real ...
Thomas Hacker. College of Michigan. October 5, 2001. Presentation ... We have been attempting to ...
Activity from NRCS Office of Farmland Protection & Community Planning ... Multi-family condo str ...
Location issues encompassing end-of-life consideration and defenseless more seasoned grown-ups . ...
Composes sentimental tension and paranormal romance books. Her goes to numerous spots ... Most l ...
Deafness is seen as an inability
Feature clasps of up and coming attractions. You are heading to Vegas. You hear ... Assigned Car ...
Feature : Video records (Quicktime, AVI, and so on.) RealVideo & RealAudio : Streaming RealVideo ...
An Interim Report from the Trenches: Using STM. Michael L. Scott University of Rochester ww ...
Alleghany County Public Schools Community Survey. Overview of Methodology and Findings. Cond ...
What is an end mark?. An end imprint is otherwise called accentuation, andcomes toward the end o ...
MANWEILER TELECOM CONSULTING, LLC. The Vision for Pinal and Gila Counties. To be controlled by t ...
Overview Launched in first Qtr 2008. Dmrkynetec sent study bundles in three waves from late Janu ...
Conceded from a SNF with a CHF exacerbation3 hospitalizations in 2 months:
Dr. John T. Stevenson. Family LifeAcademic Life. John T. Stevenson. Family LifeAcademic LifeProf ...
2. End-to-End Data Processing. Quality Assurance Data Processing Calibration