Physician Perceptions and Beliefs Regarding End-of-Life Care in a Central California Health System.

We sought to describe the preparedness, beliefs, and experience regarding end-of-life (EOL) care for in-training and attending physicians. We hoped to clarify how medical training impacts views about EOL, and topics where physicians desire more EOL training. An online anonymous survey was sent to 766 physicians who worked at Community Medical Centers in Fresno, California from October to December 2016.

Crisis Standards of Care Guidelines for the COVID-19 Pandemic: Fresno Resource Allocation Guide (FRAG).

The coronavirus disease 2019 (COVID-19) pandemic has forced healthcare providers and policymakers to look candidly at the possibility that critical care resources, such as ventilators, medical staff, extracorporeal membrane oxygenation (ECMO), bilevel positive airway pressure (BiPAP) machines, and high-flow oxygen, may become scarce or depleted if the virus continues to move throughout the United States unabated. With hospitalizations and ICU occupancy rates rapidly increasing all over the US, we must face the uncomfortable truth that a triage system, much like on the battlefields of war, will need to be implemented. Ethical concerns abound, but the process for addressing limited resources must continue to be explored.

Earlier Palliative Care Referrals Associated with Reduced Length of Stay and Hospital Charges.

Inpatient palliative care consultation services have been shown to have a dramatic impact on the time cancer patients spend in the hospital, which directly affects overall health care charges and expenditures. Our study looks at early palliative care consults in patients with a variety of chronic medical conditions as well as cancer. This is a retrospective case-control study of patients referred to the palliative care department from April 2014 to June 2016.

Culture Shift: Building an Awareness of Our Mortality.

The end of life discussions can often be difficult for a multitude of reasons. Our culture is pervasive with ideas of mortality, and that medicine can avert this human constant. Medicine, as a field, must embrace our limitations so that we can engage in honest discussions with the families and the patients regarding the end of life care.

Impact of Race/Ethnicity on Pain Management Outcomes in a Community-Based Teaching Hospital Following Inpatient Palliative Care Consultation.

Objective: To examine race/ethnicity differences in pain management outcomes following inpatient palliative care consultation.

Methods: We conducted a retrospective study based on data from a community-based teaching hospital in Fresno, CA, USA, from April 2014 to July 2015. One hundred sixty-one patients with life-limiting diagnoses and palliative care pain-related consultations were included.