Comfort Care: Difference between revisions

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Comfort care, [[ACP C]], palliation
{{Project
|ProjectActive=legacy
|ProjectProgram=CC and Med
|ProjectRequestor=Internal
|ProjectCollectionStartDate=2013-11-11
|ProjectCollectionStopDate=2019-08-26
|Project={{PAGENAME}}
}}
{{LegacyContent
|explanation=This concept is now essentially a twin of [[Palliative care]], so collection no longer needed.
|successor=[[Palliative care]]
|content=


===Data Use and Purpose===
This article is about collecting the "Comfort care" ([[ACP C]], [[Palliative care]]) temp entry. Collection has stopped, see [[Palliative care]] for a related thing we collect.
*ICU and Medicine Program
*The purpose is to specifically identify and tag those patients for whom the '''initial goal of care right from the start of a unit admission''' is comfort care, [[ACP C]], palliation.


Palliation, palliative care, comfort care, '''does not require [[Palliative Service]]''', but can include it.
== Data Use and Purpose ==
=== Which patients qualify ===
The purpose is to specifically identify and tag '''only''' those ICU and Medicine patients for whom the '''initial goal''' of care right from the start of a unit admission is comfort care, [[ACP C]], palliation.


==Start and stop date==
Pts for whom comfort care is ordered '''after admission do ''not'' qualify.'''
*Start Date: 2013-Nov-11
*Stop Date: none


=== Collection Instructions for Medicine and ICU===
Pt '''does not require''' but could be receiving [[Palliative Service]]'''.
*Where: ccmdb '''TMP''' [[L_TmpV2]]:
 
Pt ''could'' be receiving some medical treatments like treating an pneumonia or infection, pain, dehydration and anything else that would ease suffering.
 
Select Comfort Care only if '''any''' of the following are true: 
*(a) the patient had an ACP-C ''prior to'' admission to that unit/ward
*(b) the patient had an ACP-C order implemented as ''part of'' the admission orders to that unit/ward
*(c) the ''initial admission note'' of the unit/ward attending physician and/or the H&P written by the house officer identifies that the patient was admitted for any of: 
**(i) comfort care,
**(ii) palliation
**(iii) palliative care
**(iv) or end-of-life care 
***Note that none of items (ii)-(iv) require that the patient was ACP-C or that the Palliative Care Service be involved in care.
 
=== Coding Instructions ===
If the patient meets the above criteria then code as:
*In [[CCMDB.accdb]] '''TMP''' tab add:
**PROJECT: Comfort Care
**PROJECT: Comfort Care
**ITEM: Comfort Care
**ITEM: Comfort Care
#coded as "yes" if '''any''' of the following are true: 
**Checkbox, dates, numbers: Don't need to fill, not used for this project
#*(a) the patient had an ACP-C ''prior to'' admission to that unit/ward
#*(b) the patient had an ACP-C order implemented as ''part of'' the admission orders to that unit/ward
#*(c) the ''initial admission note'' of the unit/ward attending physician and/or the H&P written by the house officer identifies that the patient was admitted for any of: 
#**(i) comfort care,  
#**(ii) palliation
#**(iii) palliative care
#**(iv) or end-of-life care 
#***Note that none of items (i)-(iii) require that the patient was ACP-C or that the Palliative Care Service be involved in care.   
 
Admit DX's would use the same process as we always do.  Most significant Medical problem in admit 1, 2, 3 etc.
 
''INTENT of care is clear right '''from the beginning''' of a ward admission'' that it is for comfort care, ACP C, palliation, end of life care. This does not preclude having some medical treatments like treating an pneumonia or infection, pain, dehydration and anything else that would ease suffering.


====Example====
{{Data Integrity Check List|}}
Patient comes to CTU/S4 with a Dr.'s note/order stated intent of care is for comfort care/ACP C. Pt has Dx of CVA, CAP, cancer. 
*Admit DX would be:  1. CVA 2. CAP, 3 CA  which ever one is the primary problem first.  Could be CAP because had CVA last week.
*TMP
**Project: Comfort Care
**Item: Comfort Care


== Reporting and Analysis ==
== Data use / Reporting and Analysis ==
{{discussion}} which reports will this affect? Chances are some that previously reported [[Palliative Service]]'s predecessor should use this now... Ttenbergen 21:58, 2013 November 17 (CST)
The data is used to exclude patients in the analysis of the [[ALERT Scale]] in the [[Directors Quarterly and Annual Report (Medicine)]].


[[Category: Medicine Elements]]
== Related articles ==
[[Category: All Projects Medicine Only]]
{{Related Articles}}
[[Category: End-of-life related data]]


** If a pt. is admitted to ward for sepsis & it is determined by house/attending staff 48 hours after admission to provide comfort care only /ACPC this pt will not be captured.  Do you want to track this type of pt?
[[Category:End-of-life related data]]
}}

Latest revision as of 20:06, 2022 February 17

Projects
Active?: legacy
Program: CC and Med
Requestor: Internal
Collection start: 2013-11-11
Collection end: 2019-08-26

Legacy Content

This page contains Legacy Content.

Click Expand to show legacy content.

This article is about collecting the "Comfort care" (ACP C, Palliative care) temp entry. Collection has stopped, see Palliative care for a related thing we collect.

Data Use and Purpose

Which patients qualify

The purpose is to specifically identify and tag only those ICU and Medicine patients for whom the initial goal of care right from the start of a unit admission is comfort care, ACP C, palliation.

Pts for whom comfort care is ordered after admission do not qualify.

Pt does not require but could be receiving Palliative Service.

Pt could be receiving some medical treatments like treating an pneumonia or infection, pain, dehydration and anything else that would ease suffering.

Select Comfort Care only if any of the following are true:

  • (a) the patient had an ACP-C prior to admission to that unit/ward
  • (b) the patient had an ACP-C order implemented as part of the admission orders to that unit/ward
  • (c) the initial admission note of the unit/ward attending physician and/or the H&P written by the house officer identifies that the patient was admitted for any of:
    • (i) comfort care,
    • (ii) palliation
    • (iii) palliative care
    • (iv) or end-of-life care
      • Note that none of items (ii)-(iv) require that the patient was ACP-C or that the Palliative Care Service be involved in care.

Coding Instructions

If the patient meets the above criteria then code as:

  • In CCMDB.accdb TMP tab add:
    • PROJECT: Comfort Care
    • ITEM: Comfort Care
    • Checkbox, dates, numbers: Don't need to fill, not used for this project

Data Integrity Checks (automatic list)

 AppStatus
Query s tmp comfort care gt oneCCMDB.accdbretired

Data use / Reporting and Analysis

The data is used to exclude patients in the analysis of the ALERT Scale in the Directors Quarterly and Annual Report (Medicine).

Related articles

Related articles:
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Comfort_Care&oldid=154809"