Comfort Care

Not implemented yet. Coming to a laptop near you soon: TMP STUDY

Comfort care, ACP C, palliation

Data Use and Purpose

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

NOTE: Palliation, palliative care, comfort care, does not require Palliative Service, but can include it.

Collection Instructions for Medicine and ICU

• Where: ccmdb TMP L_TmpV2:
  • PROJECT: Comfort Care
  • ITEM: Comfort Care

1. coded as “yes” 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 (i)-(iii) require that the patient was ACP-C or that the Palliative Care Service be involved in care.
2. Admit DX's would use the same process as we always do. Most significant Medical problem in admit 1, 2, 3 etc.

Note 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: a 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