Background: Clinicians face substantial challenges in limiting life-prolonging interventions (e.g., ICU admission, life-sustaining treatments, invasive procedures) near the end of life, even when they judge these interventions to be non-beneficial [1-3]. The objective of our study was to empirically derive a descriptive framework of decision-making approaches used by clinicians to limit (i.e., withhold or withdraw) [...]

Background: Patients from diverse sociocultural backgrounds and with differing medical conditions may have varying levels of acceptance of advanced care planning which is a process in which patients of any age or health status document future care preferences. It can encompass do-not-resuscitate (DNR) orders, directives to withhold cardiopulmonary resuscitation in the event of cardiac arrest [...]

Background: Healthcare system high utilizers create a financial burden raising healthcare costs and quality improvement measures should be assessed to create a positive change. We aimed to characterize the high-utilizer patients in our system to create tailored interventions to address their specific needs and ultimately reduce recurrent admissions. Methods: A quality improvement project was implemented [...]

Background: Advance Care Planning (ACP), palliative care (PC), and enrolling inpatients near end of life into hospice are known methods to improve patient experience and reduce inappropriate use of inpatient (IP) resources. We sought to increase ACP, PC, and hospice referral by proactively identifying patients near end of life. Methods: In 2020 we introduced the [...]

Case Presentation: A 70 year old female with metastatic cholangiocarcinoma, heart failure with reduced ejection fraction, stage 4 chronic kidney disease and pulmonary embolism on anticoagulation presented to a NYC safety net hospital with bilateral lower extremity edema, dyspnea at rest and a recent unwitnessed fall. Her malignancy was diagnosed 7 months prior and her [...]