Jacqueline M. Kruser
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View article: The <scp>ICU</scp> Care Plan: Human‐Centered Design of a Tool to Support Time‐Limited Trials for Older Adults With Critical Illness
The <span>ICU</span> Care Plan: Human‐Centered Design of a Tool to Support Time‐Limited Trials for Older Adults With Critical Illness Open
Background For older adults with critical illness, decisions about life‐sustaining therapies can be challenging. A time‐limited trial (TLT) is a collaborative care plan endorsed by experts in palliative and critical care to help navigate t…
View article: Comparing Outcomes Amongst Mechanically Ventilated Patients Who Are Transferred vs Retained in a Large Health System
Comparing Outcomes Amongst Mechanically Ventilated Patients Who Are Transferred vs Retained in a Large Health System Open
View article: How Health Care Systems Shape End-of-Life Care—A Step Toward Transparency
How Health Care Systems Shape End-of-Life Care—A Step Toward Transparency Open
View article: Evaluation of the Association Between Surrogate-reported Goals of Care and Care Delivery for Critically Ill Patients in the Intensive Care Unit
Evaluation of the Association Between Surrogate-reported Goals of Care and Care Delivery for Critically Ill Patients in the Intensive Care Unit Open
View article: Characterizing the Documentation of Time-Limited Trials in Goals of Care Notes
Characterizing the Documentation of Time-Limited Trials in Goals of Care Notes Open
View article: Study protocol for a randomized controlled trial: Integrating the ‘Time-limited Trial’ in the emergency department
Study protocol for a randomized controlled trial: Integrating the ‘Time-limited Trial’ in the emergency department Open
Introduction Time-limited trial (TLT) is a structured approach between clinicians and seriously ill patients or their surrogates to discuss patients’ values and preferences, prognosis, and shared decision-making to use specific therapies f…
View article: Characterizing the Use of Time-Limited Trials in Patients With Acute Respiratory Failure: A Prospective, Single-Center Observational Study
Characterizing the Use of Time-Limited Trials in Patients With Acute Respiratory Failure: A Prospective, Single-Center Observational Study Open
IMPORTANCE: A time-limited trial (TLT) is a collaborative plan among clinicians, patients, and families to use life-sustaining therapy for a defined duration, after which the patient’s response informs whether to continue care directed tow…
View article: Interhospital Transfer of Patients With Acute Respiratory Failure in the United States: A Scoping Review
Interhospital Transfer of Patients With Acute Respiratory Failure in the United States: A Scoping Review Open
OBJECTIVES: Interhospital transfer of patients with acute respiratory failure (ARF) is relevant in the current landscape of critical care delivery. However, current transfer practices for patients with ARF are highly variable, poorly forma…
View article: Better Conversations for Better Informed Consent: Talking with Surgical Patients
Better Conversations for Better Informed Consent: Talking with Surgical Patients Open
For more than sixty years, surgeons have used bioethical strategies to promote patient self‐determination, many of these now collectively described as “informed consent.” Yet the core framework—understanding, risks, benefits, and alternati…
View article: A Framework of Clinician-Reported Approaches to Limiting Life-Prolonging Interventions Near the End of Life (RP114)
A Framework of Clinician-Reported Approaches to Limiting Life-Prolonging Interventions Near the End of Life (RP114) Open
View article: Barriers and Facilitators to End-of-Life Care Delivery in ICUs: A Qualitative Study
Barriers and Facilitators to End-of-Life Care Delivery in ICUs: A Qualitative Study Open
OBJECTIVES: To understand frontline ICU clinician’s perceptions of end-of-life care delivery in the ICU. DESIGN: Qualitative observational cross-sectional study. SETTING: Seven ICUs across three hospitals in an integrated academic health s…
View article: Navigating the uncertainty of critical illness: the role of a time-limited trial
Navigating the uncertainty of critical illness: the role of a time-limited trial Open
"Navigating the uncertainty of critical illness: the role of a time-limited trial." American Journal of Respiratory and Critical Care Medicine, 209(3), pp. P1–P2
View article: Defining the Time-limited Trial for Patients with Critical Illness: An Official American Thoracic Society Workshop Report
Defining the Time-limited Trial for Patients with Critical Illness: An Official American Thoracic Society Workshop Report Open
In critical care, the specific, structured approach to patient care known as a "time-limited trial" has been promoted in the literature to help patients, surrogate decision makers, and clinicians navigate consequential decisions about life…
View article: Identifying Patterns of Medical Intervention in Acute Respiratory Failure: A Retrospective Observational Study
Identifying Patterns of Medical Intervention in Acute Respiratory Failure: A Retrospective Observational Study Open
IMPORTANCE: Characterizing medical interventions delivered to ICU patients over time and their relationship to outcomes can help set expectations and inform decisions made by patients, clinicians, and health systems. OBJECTIVES: To determi…
View article: The Duality of “Goals of Care” Language: A Qualitative Focus Group Study With Frontline Clinicians
The Duality of “Goals of Care” Language: A Qualitative Focus Group Study With Frontline Clinicians Open
Frontline palliative and critical care clinicians understand a duality in GOC, as an idealized concept and as an expeditious signal for clinical care. Our findings suggest ambiguous phrases like GOC persist because of unmet needs for bette…
View article: Innovations in Surgical Communication 2—Focus on the Goals of Surgery
Innovations in Surgical Communication 2—Focus on the Goals of Surgery Open
This Viewpoint discusses communicating goals of surgeries with patients.
View article: Reconsidering the Language of Serious Illness
Reconsidering the Language of Serious Illness Open
This Viewpoint expresses how use of certain language complicates decision-making for critically ill patients, and it highlights alternative phrasing for effective communication.
View article: An Adjudication Protocol for Severe Pneumonia
An Adjudication Protocol for Severe Pneumonia Open
Background Clinical end points that constitute successful treatment in severe pneumonia are difficult to ascertain and vulnerable to bias. The utility of a protocolized adjudication procedure to determine meaningful end points in severe pn…
View article: Using the Hospital Frailty Risk Score to assess mortality risk in older medical patients admitted to the intensive care unit
Using the Hospital Frailty Risk Score to assess mortality risk in older medical patients admitted to the intensive care unit Open
Among patients readmitted to hospital within 12 months, patients with high frailty risk were similarly likely as those with lower frailty risk to be admitted to the ICU but were more likely to die if admitted to ICU. The HFRS at hospital d…
View article: Comparing postacute care healthcare charges after hospitalisation due to influenza or COVID-19 infection in an all-payer administrative dataset in the USA: a retrospective cohort study
Comparing postacute care healthcare charges after hospitalisation due to influenza or COVID-19 infection in an all-payer administrative dataset in the USA: a retrospective cohort study Open
Objective SARS-CoV-2 infection often causes a persistent syndrome of multiorgan dysfunction with symptoms that may be debilitating. Individuals seeking care for this syndrome are likely to generate significant healthcare utilisation and sp…
View article: Machine learning links unresolving secondary pneumonia to mortality in patients with severe pneumonia, including COVID-19
Machine learning links unresolving secondary pneumonia to mortality in patients with severe pneumonia, including COVID-19 Open
BACKGROUNDDespite guidelines promoting the prevention and aggressive treatment of ventilator-associated pneumonia (VAP), the importance of VAP as a driver of outcomes in mechanically ventilated patients, including patients with severe COVI…
View article: Mapping the process of ICU care delivery to improve treatment decisions in acute respiratory failure
Mapping the process of ICU care delivery to improve treatment decisions in acute respiratory failure Open
Evidence suggests system-level norms and care processes influence individual patients' medical decisions, including end-of-life decisions for patients with critical illnesses like acute respiratory failure. Yet, little is known about how t…
View article: Impact of Interprofessional Teamwork on Aligning Intensive Care Unit Care with Patient Goals: A Qualitative Study of Transactive Memory Systems
Impact of Interprofessional Teamwork on Aligning Intensive Care Unit Care with Patient Goals: A Qualitative Study of Transactive Memory Systems Open
Rationale: Although aligning care with patient goals is fundamental to critical care, this process is often delayed and leads to conflict among patients, families, and intensive care unit (ICU) teams. Interprofessional collaboration…
View article: An Adjudication Protocol for Severe Bacterial and Viral Pneumonia
An Adjudication Protocol for Severe Bacterial and Viral Pneumonia Open
Rationale Clinical endpoints that constitute successful treatment in severe pneumonia are difficult to ascertain and vulnerable to bias. Utility of a protocolized adjudication procedure to determine meaningful endpoints in severe pneumonia…
View article: A machine learning approach identifies unresolving secondary pneumonia as a contributor to mortality in patients with severe pneumonia, including COVID-19
A machine learning approach identifies unresolving secondary pneumonia as a contributor to mortality in patients with severe pneumonia, including COVID-19 Open
Background Patients with severe SARS-CoV-2 pneumonia experience longer durations of critical illness yet similar mortality rates compared to patients with severe pneumonia secondary to other etiologies. As secondary bacterial infection is …
View article: Patient-Centered and Family-Centered Care in the Intensive Care Unit
Patient-Centered and Family-Centered Care in the Intensive Care Unit Open
View article: Individual target pharmacokinetic/pharmacodynamic attainment rates among meropenem-treated patients admitted to the ICU with hospital-acquired pneumonia
Individual target pharmacokinetic/pharmacodynamic attainment rates among meropenem-treated patients admitted to the ICU with hospital-acquired pneumonia Open
Objectives Critical illness reduces β-lactam pharmacokinetic/pharmacodynamic (PK/PD) attainment. We sought to quantify PK/PD attainment in patients with hospital-acquired pneumonia. Methods Meropenem plasma PK data (n = 70 patients) were m…
View article: The Science of Context: Transforming Serious Illness Care Though In Situ Observation
The Science of Context: Transforming Serious Illness Care Though In Situ Observation Open
View article: Derivation and performance of an end-of-life practice score aimed at interpreting worldwide treatment-limiting decisions in the critically ill
Derivation and performance of an end-of-life practice score aimed at interpreting worldwide treatment-limiting decisions in the critically ill Open
View article: Time-limited trials in the ICU: a mixed-methods sequential explanatory study of intensivists at two academic centres
Time-limited trials in the ICU: a mixed-methods sequential explanatory study of intensivists at two academic centres Open
Objective To understand intensivist perceptions of the appropriateness of time-limited trials (TLTs)—a strategy to align life-sustaining care with patient goals and values in the midst of clinical uncertainty. Design We conducted a mixed-m…