Demedicalizing the End of Life

Project Details

  • Departments/Divisions: Hospitalist Medicine, General Internal Medicine, Palliative Care
  • Physician Leads: Dr. Chloe Lemire-Elmore, Hospitalist; Dr. Brian Mc Ardle, General Internal Medicine; Dr. Jess Nathan, Palliative Care
  • Budget: $10,195.00

About the Project

Dr. Chloe Lemire-Elmore, Dr. Brian Mc Ardle, and Dr. Jess Nathan wondered if they could improve care for their patients at or nearing their natural end of life. They hoped that these improvements could be achieved partially by reducing the number of medical and surgical procedures which, in some cases, were causing more harm than good for people with chronic diseases or life limiting illnesses. The team hoped to increase awareness of the MOST M2 category in their work in acute care, particularly their frail elderly population. Part of this work aimed to increase physicians’ comfort with Goals of Care conversations, Serious Illness Conversations, as well as increased documentation of these discussions in the ACP power form in Cerner.

The team drew from specialties and general practice colleagues in Palliative Care (Jody Anderson), General Internal Medicine (Vanja Petrovic), Geriatrics (Josh Budlovsky), Intensive Care (Adam Thomas, Shavaun MacDonald), Emergency Medicine (Tristan Jones, Ali Yakhshi Tafti), Public Health (Lisa Cairns), as well as the project management skills of Charlotte Bryan.

To achieve their goal, the team sought out opportunities to socialize the concept of the M2 category with their colleagues, through Flash Focus lunches, presentations at staff meetings, and working group meetings. As they did, increasing numbers of people became involved, with spin-off engagements happening with specialist groups including oncology and Long-Term Care.

At the end of phase one of this project, the team felt they had increased the use of M2 and raised awareness of the harm that can result from treating death and dying as an acute illness. They also identified a host of other initiatives to achieve their overarching goal and secured a Phase 2 grant to support this work.

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