Publications by authors named "Jeanie Youngwerth"

Background: Hospitalized patients with palliative care needs often have high levels of physical and psychological symptom distress. Virtual reality (VR) with a music therapy intervention may improve physical and psychological symptoms.

Objectives: To assess symptom distress and quality of life (QOL) among hospitalized palliative care patients who participated in a virtual reality-based music therapy (VR-MT) intervention, and to explore VR-MT from the perspectives of health care professionals involved in their care.

View Article and Find Full Text PDF
Article Synopsis
  • A clinical care pathway was implemented in the emergency department (ED) to help identify patients who might benefit from hospice care, aiming to improve patient outcomes.
  • After the implementation, the number of patients referred to hospice increased, and the average length of stay in the ED for these patients decreased by nearly 3 hours.
  • The initiative also led to more social work consultations, with patients being discharged to hospice care and a reduction in hospital admission duration.
View Article and Find Full Text PDF
Article Synopsis
  • - The COVID-19 pandemic increased the need for effective advance care planning (ACP) in hospitals, prompting healthcare systems to innovate their approaches to ensure patients' care aligns with their goals.
  • - A study evaluated the effectiveness of a social work and care management intervention that aimed to increase the number of hospitalized patients with a Medical Durable Power of Attorney (MDPOA) by assisting them in selecting decision-makers and completing necessary forms.
  • - Results showed a significant increase in MDPOA forms completed, from 30.1% to 42.8%, demonstrating that change management strategies can quickly enhance ACP initiatives, though ongoing efforts are needed for sustainability and provider education.
View Article and Find Full Text PDF

Music therapy (MT) and virtual reality (VR) have shown favorable patient-reported outcomes during serious illness. To evaluate implementation measures of feasibility, usability, and acceptability of a VR-based MT intervention. A pilot implementation study of a two-day VR-MT intervention using mixed methods.

View Article and Find Full Text PDF

Objectives: The objectives are as follows: 1) estimate palliative care consult rates and trends among critically ill children and 2) characterize which children receive palliative care consults, including those meeting previously proposed ICU-specific palliative care screening criteria.

Design: Retrospective cohort.

Setting: Fifty-two United States children's hospitals participating in the Pediatric Health Information Systems database.

View Article and Find Full Text PDF

Objective: Large health systems responding to the coronavirus disease 2019 (COVID-19) pandemic face a broad range of challenges; we describe 14 examples of innovative and effective informatics interventions.

Materials And Methods: A team of 30 physician and 17 nurse informaticists with an electronic health record (EHR) and associated informatics tools.

Results: To meet the demands posed by the influx of patients with COVID-19 into the health system, the team built solutions to accomplish the following goals: 1) train physicians and nurses quickly to manage a potential surge of hospital patients; 2) build and adjust interactive visual pathways to guide decisions; 3) scale up video visits and teach best-practice communication; 4) use tablets and remote monitors to improve in-hospital and posthospital patient connections; 5) allow hundreds of physicians to build rapid consensus; 6) improve the use of advance care planning; 7) keep clinicians aware of patients' changing COVID-19 status; 8) connect nurses and families in new ways; 9) semi-automate Crisis Standards of Care; and 10) predict future hospitalizations.

View Article and Find Full Text PDF

In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

View Article and Find Full Text PDF

Background: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public.

Objective: Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard.

Design: The scorecard was organized into a format of quality measures identified by the Measuring What Matters (MWM) project that are defined as important to the team, automatically extracted from the electronic health record, valid, and can be impacted over time.

View Article and Find Full Text PDF

Background: Patients with neurological disorders are the second most common patient population to receive inpatient palliative care services after cancer; however, there have been few reports describing the characteristics and needs of this population.

Objective: To understand which patients with neurological diagnoses utilized these services, reasons for consultation, and whether patterns of use changed over time.

Design: Retrospective case series.

View Article and Find Full Text PDF

Background: Identifying patients, at the time of hospital admission, who are at high risk for 1-year mortality is an ideal opportunity to introduce palliative interventions into the hospital care plan. The CARING (C = primary diagnosis of cancer, A = ≥ 2 admissions to the hospital for a chronic illness within the last year; R = resident in a nursing home; I = intensive care unit admission with multiorgan failure, NG = noncancer hospice guidelines [meeting ≥ 2 of the National Hospice and Palliative Care Organization's guidelines] criteria is a practical prognostic index developed and validated in the Veteran's Administration hospital setting that identifies patients at high risk of death within 1 year, although its effectiveness in a broader patient population is unknown.

Objective: To validate the CARING criteria in a university and safety-net hospital setting.

View Article and Find Full Text PDF

Background: Palliative care services are lacking in rural hospitals. Implementing palliative care services in rural and remote areas requires knowledge of available resources, specific barriers, and a commitment from the hospital and community.

Objective: The purpose of the study was to determine awareness, knowledge, barriers, and resources regarding palliative care services in rural hospitals.

View Article and Find Full Text PDF

Background: Palliative care has been recommended as an approach to improve the quality of care for patients with advanced illness, while achieving hospital cost savings. However, studies are lacking that identify hospitalized patients who are more likely to have higher cost per day or length of stay (LOS) who may benefit from palliative care consultation.

Objective: Identify characteristics associated with higher cost per day or longer LOS in hospitalized patients at the end of life--those likely to benefit from palliative care consultation.

View Article and Find Full Text PDF