ABSTRACT
Resuscitation codes in the hospital are intensely stressful events that impact the goals and outcomes of patients. Regardless of the outcome of the code, the event itself can be traumatic for the patient, surrogate decision makers, and health care team. The unique skills of each interdisciplinary specialty palliative care team member can assist with each step of the code to improve support and minimize suffering. We discuss a case of a hospitalized patient for whom a code blue was called and the roles of each specialty palliative care team member before, during, and after the event.
Subject(s)
Cardiopulmonary Resuscitation , Hospice and Palliative Care Nursing , Humans , Palliative Care , Patient Care Team , PatientsABSTRACT
Background: Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality rate and significantly impacts survivors' quality of life. Objective: To assess impact of specialty palliative care services (sPCS) among patients hospitalized with aSAH. Design: A retrospective cohort study using the National Inpatient Sample (2017-2018). Setting/Subjects: U.S. adult patients hospitalized for aSAH with and without sPCS involvement. Measurements: Mortality and health care utilization variables. Results: Among 48,050 patients with aSAH, 12.7% received sPCS input. aSAH patients with sPCS were more likely to be sicker (higher National Inpatient Sample-subarachnoid hemorrhage [NIS-SAH] severity score, p < 0.01). Patients with sPCS had a 70% in-hospital mortality rate, whereas only 9% of the rest of this cohort died during the incident hospitalization (p < 0.01). Those with sPCS involvement had shorter lengths of stay (p < 0.05) and nonsignificantly lower hospital charges. Conclusion: sPCS involvement, inferred by International Classification of Diseases, 10th Revision (ICD-10) code Z51.5, was associated with shorter length of stay and lower hospital charges among survivors, but this did not meet prespecified statistical significance. There may be significant benefits to consulting sPCS for patients hospitalized with aSAH.
Subject(s)
Subarachnoid Hemorrhage , Adult , Hospitalization , Humans , Palliative Care , Quality of Life , Retrospective Studies , Subarachnoid Hemorrhage/therapy , United StatesABSTRACT
Previous reports have identified the development of healthcare coalitions as the foundation for disaster response across the United States. This survey of acute care hospitals characterizes the current status of participation by US hospitals in healthcare coalitions for emergency preparedness planning and response. The survey results show the nearly universal nature of a coalition approach to disaster response. The results suggest a need for wide stakeholder involvement but also for flexibility in structure and organization. Based on the survey results, the authors make recommendations to guide the further development of healthcare coalitions and to improve local and national response to disasters.
