Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Lawrence Center for Quality and Safety, Massachusetts General Hospital and Massachusetts General Physicians' Organization, Boston, Massachusetts, USA.
Department of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
J Pain Symptom Manage. 2020 Nov;60(5):e35-e43. doi: 10.1016/j.jpainsymman.2020.08.007. Epub 2020 Aug 31.
Although the importance of palliative care (PC) integration in the emergency department (ED) has long been recognized, few formalized programs have been reported, and none have evaluated the experience of ED clinicians with embedded PC.
We evaluate the experience of ED clinicians with embedded PC in the ED during the coronavirus disease pandemic.
ED clinicians completed a survey about their perceptions of embedded PC in the ED. We summarized responses to closed-ended items using descriptive statistics and analyzed open-ended items using thematic analysis.
There were 134 ED clinicians surveyed. About 101 replied (75% response rate). Of those who had interacted with PC, 100% indicated a benefit of having PC involved. These included freeing up ED clinicians for other tasks (89%), helping them feel more supported (84%), changing the patients care trajectory (67%), and contributing to clinician education (57%) and skills (49%). Among barriers related to engaging PC were difficulty locating them (8%) and lack of time to consult because of ED volume (5%). About 98% of respondents felt that having PC in the ED was either valuable or very valuable. Open-ended responses reflected a positive impact on clinician wellness and improvement in access to high-quality goal-concordant care. Clinicians expressed gratitude for having PC in the ED and noted the importance of having readily available and easily accessible PC in the ED.
ED clinicians' perception of embedded PC was overall positive, with an emphasis on the impact related to task management, enrichment of PC skills, providing support for the team, and improved care for ED patients.
虽然姑息治疗（PC）融入急诊部（ED）的重要性早已得到认可，但很少有正式的项目得到报道，也没有评估 ED 临床医生对嵌入式 PC 的体验。
我们评估了在冠状病毒病大流行期间 ED 临床医生在 ED 中嵌入 PC 的体验。
ED 临床医生完成了一份关于他们对 ED 中嵌入式 PC 的看法的调查。我们使用描述性统计数据总结了对封闭式问题的回答，并使用主题分析对开放式问题进行了分析。
共有 134 名 ED 临床医生接受了调查。约有 101 人（75%的回复率）回复。在与 PC 互动的人中，有 100%的人表示 PC 的参与有好处。这些好处包括让 ED 临床医生腾出时间处理其他任务（89%），帮助他们感到更受支持（84%），改变患者的治疗轨迹（67%），并有助于临床医生的教育（57%）和技能（49%）。与参与 PC 相关的障碍包括难以找到他们（8%）和由于 ED 量而缺乏咨询时间（5%）。约 98%的受访者认为 ED 中有 PC 是有价值的或非常有价值的。开放式回答反映了对临床医生健康的积极影响，并改善了获得高质量目标一致的护理的机会。临床医生对 ED 中有 PC 表示感谢，并指出 ED 中拥有随时可用且易于获得的 PC 非常重要。
ED 临床医生对嵌入式 PC 的总体看法是积极的，重点是与任务管理、丰富 PC 技能、为团队提供支持以及改善 ED 患者护理相关的影响。
