Comparing Adherence with Best Practices in End-of-Life Care After Implementing the End-of-Life Order Set: A Quality Improvement Project in an Ottawa Academic Hospital Article Swipe
Grace Warmels
,
Anne C. Roberts
,
John G. Haddad
,
Marie‐Hélène Chomienne
,
Shirley H. Bush
,
Valérie Gratton
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1089/pmr.2022.0070
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1089/pmr.2022.0070
Background: Physicians in acute care require tools to assist them in transitioning patients from a “life prolonging” approach to “end-of-life care,” and standardized order sets can be a useful strategy. The end-of-life order set (EOLOS) was developed and implemented in the medical wards of a community academic hospital. Objective: To compare adherence with best practices in end-of-life care after implementing the EOLOS. Methods: We conducted a retrospective chart review of admitted patients with expected deaths in the year preceding EOLOS implementation (“before EOLOS” group), and in the 12 to 24 months following EOLOS implementation (“after EOLOS” group). Results: A total of 295 charts were included: 139 (47%) in the “before EOLOS” group and 156 (53%) in the “after EOLOS” group, of which 117/156 charts (75%) had a completed EOLOS. The “after EOLOS” group demonstrated more “do not resuscitate” orders and more written communication to team members about comfort goals of care. There was a decrease in nonbeneficial interventions in the last 24 hours of life in the “after EOLOS” group: high-flow oxygen, intravenous antibiotics, and deep vein thrombosis/venous thromboembolism prophylaxis. The “after EOLOS” group demonstrated increased prescription of all common end-of-life medications, except for opioids, which had a high preexisting rate of prescription. Patients in the “after EOLOS” group showed a higher rate of spiritual care and palliative care consult team consultation. Conclusion: Findings support standardized order sets as a good framework allowing generalist hospital staff to improve adherence to established palliative care principles and improve end-of-life care of hospital inpatients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1089/pmr.2022.0070
- OA Status
- gold
- Cited By
- 2
- References
- 32
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4366001268
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4366001268Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1089/pmr.2022.0070Digital Object Identifier
- Title
-
Comparing Adherence with Best Practices in End-of-Life Care After Implementing the End-of-Life Order Set: A Quality Improvement Project in an Ottawa Academic HospitalWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2023Year of publication
- Publication date
-
2023-04-14Full publication date if available
- Authors
-
Grace Warmels, Anne C. Roberts, John G. Haddad, Marie‐Hélène Chomienne, Shirley H. Bush, Valérie GrattonList of authors in order
- Landing page
-
https://doi.org/10.1089/pmr.2022.0070Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1089/pmr.2022.0070Direct OA link when available
- Concepts
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End-of-life care, Medicine, Medical prescription, Psychological intervention, Palliative care, Quality of life (healthcare), Advance care planning, Emergency medicine, Nursing, Family medicine, Medical emergencyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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2Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 1Per-year citation counts (last 5 years)
- References (count)
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32Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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