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Enhancing end of life care on general internal medical wards: the 3 Wishes Project.
Reid, Julie C; Dennis, Brittany; Hoad, Neala; Clarke, France; Hanmiah, Rajendar; Vegas, Daniel Brandt; Boyle, Anne; Toledo, Feli; Rudkowski, Jill C; Soth, Mark; Heels-Ansdell, Diane; Cheung, Andrew; Willison, Kathleen; Neville, Thanh H; Cheung, Jason; Woods, Anne; Cook, Deborah.
  • Reid JC; Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, McMaster University Medical Centre, 1280 Main Street West, 2C Area, Hamilton, ON, L8S 4K1, Canada. reidj7@mcmaster.ca.
  • Dennis B; Department of Medicine, Faculty of Health Sciences, McMaster University, McMaster University Medical Centre, 1280 Main Street West, 2C Area, Hamilton, ON, L8S 4K1, Canada.
  • Hoad N; Department of Critical Care, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Clarke F; Department of Critical Care, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Hanmiah R; Department of Medicine, Faculty of Health Sciences, McMaster University, McMaster University Medical Centre, 1280 Main Street West, 2C Area, Hamilton, ON, L8S 4K1, Canada.
  • Vegas DB; Department of Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Boyle A; Department of Medicine, Faculty of Health Sciences, McMaster University, McMaster University Medical Centre, 1280 Main Street West, 2C Area, Hamilton, ON, L8S 4K1, Canada.
  • Toledo F; Department of Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Rudkowski JC; Department of Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Soth M; Division of Palliative Care, Department of Family Medicine, Faculty of Health Sciences, David Braley Health Sciences Centre, McMaster University, 100 Main Street West, 6th Floor, Hamilton, ON, L8P 1H6, Canada.
  • Heels-Ansdell D; Department of Spiritual Care, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Cheung A; Department of Medicine, Faculty of Health Sciences, McMaster University, McMaster University Medical Centre, 1280 Main Street West, 2C Area, Hamilton, ON, L8S 4K1, Canada.
  • Willison K; Department of Critical Care, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Neville TH; Department of Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Cheung J; Department of Medicine, Faculty of Health Sciences, McMaster University, McMaster University Medical Centre, 1280 Main Street West, 2C Area, Hamilton, ON, L8S 4K1, Canada.
  • Woods A; Department of Critical Care, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
  • Cook D; Department of Medicine, St. Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON, L8N 4A6, Canada.
BMC Palliat Care ; 22(1): 11, 2023 Feb 14.
Article in English | MEDLINE | ID: covidwho-2244567
ABSTRACT

BACKGROUND:

Initially developed in the intensive care unit (ICU) at St. Joseph's Healthcare Hamilton (SJHH) the 3 Wishes Project (3WP) provides personalized, compassionate care to dying patients and their families. The objective of this study was to develop and evaluate 3WP expansion strategies for patients cared for on General Internal Medicine (GIM) wards in our hospital.

METHODS:

From January 2020-November 2021, we developed a phased, multicomponent approach for program expansion. We enrolled patients on the GIM wards who had a high probability of dying in hospital, then elicited, implemented, and documented wishes for them or their families. Data were analyzed descriptively.

RESULTS:

From March 2020 to November 2020, we implemented staff education and engagement activities, created an Expansion Coordinator position, held strategic consultations, and offered enabling resources. From March 2020 to November 2021, we enrolled 62 patients and elicited 281 wishes (median [1st, 3rd quartiles] 4 [4, 5] wishes/patient). The most common wish categories were personalizing the environment (67 wishes, 24%), rituals and spiritual support (42 wishes, 15%), and facilitating connections (39 wishes, 14%). The median [1st, 3rd] cost/patient was $0 [0, $10.00] (range $0 to $86); 91% of wishes incurred no cost to the program.

CONCLUSIONS:

The formal expansion of the 3WP on GIM wards has been successful despite COVID-19 pandemic disruptions. While there is still work ahead, these data suggest that implementing the 3WP on the GIM wards is feasible and affordable. Increased engagement of the clinical team during the pandemic suggests that it is positively received.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Terminal Care / Hospice Care / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Humans Language: English Journal: BMC Palliat Care Year: 2023 Document Type: Article Affiliation country: S12904-023-01133-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Terminal Care / Hospice Care / COVID-19 Type of study: Experimental Studies / Prognostic study Limits: Humans Language: English Journal: BMC Palliat Care Year: 2023 Document Type: Article Affiliation country: S12904-023-01133-4