Comfort Care

see ACP Status collection in ICU for collection of similar info in Critical Care

This article is about collecting the "Comfort care" (ACP C, palliation) temp entry.

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

Start and stop date

• Start Date: 2013-Nov-11
• Stop Date: none

Template:CCMDB Data Integrity Checks

Only one entry allowed per patient. Uses query s_tmp_comfort_care_gt_one.

Data use / Reporting and Analysis

The data is used to exclude patients from analysis for Project Overstay.

The data is used to exclude patients in the analysis of the ALERT scale in the Quarterly report and Annual report.