Use of a palliative care order set to improve resident comfort with symptom management in palliative care.
Although one-fourth of all medicare dollars are spent during the last year of life, symptom management for terminal hospitalized patients has continued to be inadequate. Quality end-of-life care is often overlooked, seldom taught and rarely measured within Internal Medicine Residency Programmes. We studied the effects of a palliative care order set and educational e-mail on resident comfort. Survey of residents showed that only 54% were comfortable across nine aspects of palliative care. Three months after release, 88% of residents were using the order set and 63% believed it increased their comfort with palliative care. Resident comfort managing palliative symptoms increased an average 10% (P = 0.02). First-year residents exposed to this order set increased in comfort from 40% to 65% (P < 0.0001), which significantly surpassed the 48% of second-year residents who reported being comfortable (P = 0.002). Introducing a palliative care order set improves resident comfort with symptom management in dying patients.
Jarabek
B R
BR
Internal Medicine Residency Programme, Mayo Clinic, Rochester, MN 55905, USA. jarabek.bryan@mayo.edu
Jama
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Ruegg
S R
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Moynihan
T J
TJ
McDonald
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D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008910:Minnesota; D010166:Palliative Care / Q000379:methods / Q000592:standards*; D010347:Patient Care Planning / Q000592:standards*; D017060:Patient Satisfaction; D011787:Quality of Health Care / Q000592:standards*; D013727:Terminal Care / Q000379:methods / Q000592:standards*