The use of videophones for patient and family participation in hospice interdisciplinary team meetings: a promising approach.

Inclusion of patients and caregivers in decisions related to the delivery of care is inherent in the hospice philosophy. Telemedicine technologies offer a potential solution to the challenges presented by the geographic distance between team meetings and the home environment. While inclusion requires additional coordination by the hospice team, it also offers an important opportunity to improve communication between the team and the patient and family. A modified conceptual model based on two previous frameworks is outlined to support patient and family involvement in hospice team meetings. Further research is suggested to determine the structural feasibility of patient and family involvement via videophone as well as the structural and procedural changes resulting from this inclusion. Finally, clinical outcomes and family evaluation of the inclusion experience need to be thoroughly researched before final conclusions may be reached.

'They're part of the team': participant evaluation of the ACTIVE intervention.

This study used participant feedback to qualitatively evaluate an intervention (Assessing Caregivers for Team Intervention through Videophone Encounters [ACTIVE]) that used videophone technology to include patients and/or their family caregivers in hospice interdisciplinary team meetings. Data were generated during individual interviews with hospice staff members and family caregivers who participated in ACTIVE intervention. Modified grounded theory procedures served as the primary analysis strategy. Results indicated that ACTIVE intervention enhanced team functioning in terms of context, structure, processes and outcomes. Participants discussed challenges and offered corresponding recommendations to make the intervention more efficient and effective. Data supported the ACTIVE intervention as a way for hospice providers to more fully realise their goal of maximum patient and family participation in care planning.

First-trimester diagnosis of placenta previa percreta by magnetic resonance imaging.

Placenta previa percreta with bladder involvement is a rare but devastating complication of pregnancy. Antepartum diagnosis of this serious condition allows the obstetrician to alter his or her management of abdominal delivery and minimize the magnitude of bleeding. We report a case in which magnetic resonance imaging was able to detect placenta percreta in the first trimester. If further research demonstrates usefulness of this diagnostic modality, magnetic resonance imaging may prove to be useful in caring for patients with this condition.