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Biomedical subjects

Frank D Ferris

Publications and source records attributed to Frank D Ferris.

11 recordsLinked to original sources
PubMed2006

Evaluating the California Hospital Initiative in Palliative Services.

BACKGROUND: Inpatient palliative care programs can improve care of patients with serious illness. We developed the California Hospital Initiative in Palliative Services (CHIPS) program to assist hospitals in establishing these programs. CHIPS included an introductory conference followed by 10 months of mentoring with telephone calls, e-mails, on-site consultation at the hospital, and a reunion conference. METHODS: To evaluate CHIPS and the factors associated with establishing inpatient palliative care programs, we conducted a cross-sectional telephone survey of leaders from the 38 hospitals that participated in CHIPS. We assessed the number of inpatient palliative care consultation services established by hospitals that participated in CHIPS (success) and hospital characteristics associated with success. RESULTS: Participants gave CHIPS high ratings. Six hospitals (16%) had a palliative care consultation service at enrollment in CHIPS and 19 hospitals (60%) established one after participation in CHIPS (P<.001). In bivariable comparisons, successful hospitals were more likely to have a hospitalist program (P = .003) or to be located in an urban setting (P = .03). CONCLUSIONS: CHIPS seemed to help many hospitals establish inpatient palliative care programs. Hospitals with hospitalists and those in an urban setting were more likely to succeed in developing palliative care programs. Future studies should focus on the quantity and quality of care provided by these programs.

California↗
PubMed2005

Models, standards, guidelines.

This article reviews the current illness experience for elders, highlights key issues that cause suffering and affect the quality of life of elders in our society, and reviews the definition and the process for providing palliative care. A consensus-building process is described, which any hospice or palliative care organization can use to adapt existing consensus and evidence-based models, standards of practice, and preferred practice guidelines and engage all staff and stakeholders in the development of an organizational model to guide day-to-day practices and improve the quality of all its activities.

Aged↗
PubMed2004

Last hours of living.

The last hours of living can be one of the most important times in the life of any patient and his/her family. With appropriate preparation and careful management of the process by skilled clinicians, dying and death can be a comfortable and even rewarding experience for everyone involved. After death, careful attention to the grief of survivors can help them cope with their loss and rebuild their lives.

Advance Care Planning↗
PubMed2004

Assessment of the Education for Physicians on End-of-Life Care (EPEC) Project.

PURPOSE: Palliative medicine is assuming an increasingly important role in patient care. Yet, most physicians did not learn this during their formal training. The Education for Physicians in End-of-life Care (EPEC) Project aims to increase physician knowledge in palliative care by disseminating the EPEC Curriculum through a train-the-trainer approach. An assessment of its use to help the project reach its targets was performed. METHOD: An independent evaluation pursued a two-step qualitative and quantitative approach to assess the ways that the curriculum is used by EPEC Trainers. RESULTS: The main findings are: (1) The EPEC Curriculum is well regarded by a quota sample of 200 physicians who were trained to use the curriculum between January 1999 and March 2000. When asked, "How would you rate the effect of EPEC training on your knowledge of end-of-life care?," 62% (123/200) selected 'greatly improved it.' When asked, "What was the effect of the EPEC conference on your ability to teach end-of-life care?," 72% (144/200) selected 'greatly improved it.' (2) Dissemination has been effective. Ninety-two percent (184/200) use the curriculum for teaching. Of these, 83% (153/184) presented the material in 30-60 minute sessions as part of regularly scheduled conferences. We estimate that these 184 EPEC Trainers have presented 1 or more of the 16 EPEC Curriculum modules to approximately 120,000 professionals. DISCUSSION: There is evidence that physicians selected to be EPEC Trainers judge the EPEC Curriculum to be high in quality, respected, and most importantly, usable. They use the EPEC Curriculum as part of a train-the-trainer dissemination strategy. The interpretation of this enthusiastic assessment is tempered by the study's limitations including respondent bias and possible acquiescence. Nevertheless, it appears that the EPEC Curriculum has set a standard of knowledge in the field and is an example of disseminating new information to physicians in practice. We conclude that the EPEC Curriculum is an effective vehicle to transmit palliative care information to physicians in practice.

Curriculum↗
PubMed2003

Competency in end-of-life care: last hours of life.

Clinical competence, willingness to educate, and calm and empathic reassurance are critical to helping patients and families in the last hours of living. This review adapted from the Education for Physicians on End-of-Life Care (EPEC) Curriculum describes the predictable course that occurs as well as approaches to management. Management principles are the same at home or in a health care institution. However, death in an institution requires accommodations to assure privacy, cultural observances, and communication that may not be customary. In anticipation of the event, it helps to inform the family and other professionals about what to do and what to expect. Care does not end until the family has been supported with their grief reactions and those with complicated grief helped to get care. Care at the end of life is a core competency.

Clinical Competence↗
PubMed2002

Ensuring competency in end-of-life care: controlling symptoms.

BACKGROUND: Palliative medicine is assuming an increasingly important role in patient care. The Education for Physicians in End-of-life Care (EPEC) Project is an ambitious program to increase core palliative care skills for all physicians. It is not intended to transmit specialty level competencies in palliative care. METHOD: The EPEC Curriculum was developed to be a comprehensive syllabus including trainer notes, multiple approaches to teaching the material, slides, and videos of clinical encounters to trigger discussion are provided. The content was developed through a combination of expert opinion, participant feedback and selected literature review. Content development was guided by the goal of teaching core competencies not included in the training of generalist and non-palliative medicine specialist physicians. RESULTS: Whole patient assessment forms the basis for good symptom control. Approaches to the medical management of pain, depression, anxiety, breathlessness (dyspnea), nausea/vomiting, constipation, fatigue/weakness and the symptoms common during the last hours of life are described. CONCLUSION: While some physicians will have specialist palliative care services upon which to call, most in the world will need to provide the initial approaches to symptom control at the end-of-life.

Journal Article↗
PubMed2002

Recommendations to improve end-of-life care through regulatory change in U.S. health care financing.

Palliative care has emerged as the interdisciplinary approach to relieving suffering and improving quality of life. Unfortunately, it is not yet available to all who need it. Although legislation may ultimately be needed, regulatory changes can quickly improve the current situation. While we see many regulatory changes that are possible, just three would quickly improve care: adjust hospital payment to include essential palliative care services for hospitalized patients in pertinent Diagnostic Related Groups (DRGs); clarify physician payment for providing palliative care by clarifying guidelines for carriers and paying for case management services; and clarify the Medicare Hospice Benefit by defining the 6 month prognosis in statistical terms.

Diagnosis-Related Groups↗
PubMedDate not supplied

Assessing pain at wound dressing-related procedures.

This article is an abstract from a new guide, Principles of Best Practice: Minimising Pain at Wound Dressing-Related Procedures. It is an educational initiative of the World Union of Wound Healing Societies (WUWHS). The guide has been inspired by two seminal documents: the European Wound Management Association's position document, Pain at Wound Dressing Changes (EWMA, 2002), and Practical Treatment of Wound Pain and Trauma: A Patient-centred Approach (Reddy et al, 2003). As an international educational initiative, the WUWHS document is aimed at anyone involved in dressing-related procedures anywhere in the world. This article summarises the section on best practice in the assessment of wound pain.

Bandages↗