death by meeting …
… It’s been a few years since I added to my ongoing list of “books I wish they’d made me read in school” … Lencioni’s Death by Meeting is a penetrating parable of management culture today.
Journal Club
safety in hospice …
… Casarett and colleagues’ article cautioning against misapplying routine safety measures in the hospice setting. Fundamental differences include goals of care (comfort not cure), longevity (days to months not years) and primary caregivers (family and friends not trained health care personnel). A follow-up article would address safety measures that are appropriate and specific for hospice …
everyone has a story …
Adele V. (not her real name), mid-60s, morbidly obese, heart disease, diabetes, dependent edema that became painful by late afternoon … Adele’s husband, slim and well dressed, strides through the front door. He nods at his wife, then me, and sits without a word in the corner … What the room tells me, what her …
life review …
“In the past few decades, there has been an increase in the use of life review techniques to improve mood, cognition, and quality of life among elderly individuals. The underlying theory is that late life depression is often caused (or at least worsened) by an inability to remember the trajectory of one’s life. By reliving …
Spiritual Issues in the Care of Dying Patients …
“When I look at a patient, in this case a dying patient, I really look at the primary core spiritual need that they are presenting to me. Is it a quest for meaning to try to determine what their life meant or what their faith means? Or, are they presenting a need for affirmation, support, …
Spiritual Issues in the Care of Dying Patients … Read More »
more than policies and procedures …
Curry et. al. demonstrate that an organizational culture of trust and teamwork is the foundation for high performing quality patient care. “ … achieving high performance may require long-term investment and concerted efforts to create an organizational culture that supports full engagement in quality, strong communication and coordination among groups, and the capacity for problem …
palliative care in the icu …
roundtable discussion … CAPC IPAL-ICU website …
prognosis factors marking 6 month survival …
Salpeter et. al. summarize prognostic factors in cancer and non-cancer diagnoses that are consistently associated with a survival of 6 months or less. “Despite different cancer characteristics, a fairly universal picture of terminal disease included decreasing performance status, advancing age, weight loss, metastatic disease, disease recurrence, and laboratory abnormalities indicating extensive disease. Most of the …
grief and growth …
18 years after his stillborn daughter was born,Steven Guy said: “I have moved on; I can talk about the day she died and not cry, sometimes…She has changed me from the shy insecure person I was then to the openly emotional, caring, supportive, and strong man I am now.” The Lancet discusses grief in the …
palliative care resources …
David Weissman … Next Gen Palliative Care Diane Meier … first chapter of her Palliative Care text … interview with Diane Rehm Atul Gawande … New Yorker article NEJM study palliative care in lung cancer