Members Of Care Team Research Articles

Facilitators and barriers to reach and enrollment into a medically tailored meals program within a section 1115 Medicaid pilot: clinic staff perspectives

IntroductionMedically tailored meals (MTMs) are home-delivered, nutritionally tailored meals for individuals living with complex or advanced diet-sensitive medical conditions. In 2020, Massachusetts Medicaid implemented the Flexible Services Program (FSP) through a Section 1115 Demonstration, which funded novel nutrition programs, including MTMs, for high-risk patients through Accountable Care Organizations (ACOs). Little is known from the practitioners’ perspective regarding the facilitators and barriers to reaching and enrolling patients in MTM programs.MethodsWe interviewed 19 staff across four ACOs that had implemented MTM interventions. Interviews were conducted from Feb to Aug 2023 and included staff who participated in patient screening, referral, or enrollment. The interview guide was informed by the Health Equity Implementation Framework. Interviews were recorded and transcribed and coded using NVivo software. We used directed qualitative content analyses. The study team identified and discussed common themes and presented them back to our ACO partners.ResultsStaff described facilitators of and barriers to reach and enrollment related to several domains of the Health Equity Implementation Framework. For program (innovation) factors, facilitators included perceived positive effects on patient health outcomes and a relative advantage over both the status quo and other nutrition assistance programs; outreach by care team members rather than other staff; the eligibility criteria, which were viewed as appropriate and evidence-based; and the simplicity of the program, which aided communication with patients. Patient-related facilitators included patients being more in need of the program due to more severe illness and being more motivated to change dietary behaviors. Patient-related barriers included lacking a working phone or stable housing and concern about meals meeting taste and cultural food preferences. Staff-related barriers included limited time and especially knowledge about the MTM program.DiscussionThis study highlights the perspectives of front-line staff during the implementation of an MTM program in a state-wide 1,115 Demonstration. Staff may require multiple trainings to gain full knowledge about the program and increase self-efficacy in describing it with sensitivity. These new findings elevate voices from front-line healthcare staff in MTM delivery and can help inform strategies for effective, equitable implementation of MTM programs.

Preparing Nurses to Support the Family During Resuscitation: An Exploratory-Descriptive Qualitative Study.

The family support person role during resuscitation is complex and requires role preparation; however, there is a lack of guidance on preparing nurses for this crucial role. To examine how critical care nurses prepared for the role of supporting families during resuscitation and their perceptions of the preparation needed to fulfill this role. An exploratory-descriptive qualitative design guided the study. Individual, semistructured interviews with 16 critical care nurses yielded data for thematic analysis. All participants had been in the family support person role. Three themes emerged: who should perform the family support person role, why role preparation is important, and how to prepare for the role. The themes captured participants' views about identifying and preparing individuals to support families during resuscitation. Nurses are the ideal health care team member to support families during resuscitation. However, participants felt unprepared for this role, especially for communicating with families. Education and experience are important to prepare nurses to effectively enact the role to ensure positive outcomes for family members.

Motivational Interviewing to Address Vaccine Hesitancy in a Rural Population.

Background: Individuals experience vaccination hesitancy for many reasons. However, not receiving vaccinations leaves individuals at increased risk for vaccine-preventable illnesses. Individuals in rural areas are more likely to experience vaccine hesitancy. Objective: Motivational interviewing is an effective strategy for addressing behavior change, including vaccine hesitancy. This evidence-based practice project provided an education session for Michigan State University Extension Vaccine Team members, who deliver health care information statewide. Methods: An educational information session on motivational interviewing was delivered via Zoom. This session focused on employing motivational interviewing in rural populations to address vaccine hesitancy. A survey was administered to participants pre and postmotivational interviewing educational sessions to assess changes in knowledge and confidence in using motivational interviewing. Results: Participants' knowledge and confidence regarding motivational interviewing improved. They reported an increased understanding of the concept and confidence in deploying this technique to the rural population. Conclusions: This project highlights the process and need for delivering an educational motivational interviewing session to health care team members who regularly interact with the rural population regarding vaccine hesitancy. Implications for Nursing: Teaching individuals who regularly interact with the rural population the technique of motivational interviewing can help expand the reach of the discussions in health care settings.

Telehomecare Monitoring for Patients Receiving Anticancer Oral Therapy: Protocol for a Mixed Methods Evaluability Study.

Telehomecare monitoring (TM) in patients with cancer is a complex intervention. Research shows variations in the benefits and challenges TM brings to equitable access to care, the therapeutic relationship, self-management, and practice transformation. Further investigation into these variations factors will improve implementation processes and produce effective outcomes. This study aims to concurrently analyze implementation and evaluate the effectiveness of TM for patients receiving anticancer oral therapy. The objectives are to (1) contextualize how and why TM is implemented according to (a) site characteristics, (b) team characteristics, and (c) characteristics of patients receiving anticancer oral therapy; (2) assess TM effectiveness for recording electronic patient-reported outcome measures (ePROMs) and patient-reported experience measures (ePREMs) according to the site, implementation process, and patient characteristics; (3) describe the acceptability and feasibility of TM from the perspectives of the people directly or indirectly involved and provide evidence-based actionable guidance in anticipation of provincewide implementation. This type II hybrid effectiveness-implementation study uses a concurrent mixed methods design. Evaluability assessment is integrated into an emerging practice in 3 participating sites to enable the evaluation of implementation strategies on TM clinical outcomes. Quantitative data for ePROMs and ePREMs will be collected using validated oncology questionnaire. Descriptive statistics and repeated measures using multiple linear mixed models and generalized estimating equations analyses will be undertaken alongside interpretive descriptive coding of qualitative data. Qualitative data will be gathered from key informants guided by the RE-AIM (reach, efficacy, adoption, implementation, maintenance) framework and its extension, PRISM (practical robust implementation and sustainability model). The concurrent approach allows results at multiple stages of this study to be integrated iteratively. The methodological choice aims to provide real-world data that are rigorous, rapidly usable in practice, and transferable to other settings. Questionnaires were pretested and the technological platform was codeveloped with members of the cancer care team and patients. Preparatory work was carried out to configure the TM platform and activate coordinating mechanisms between members of the cancer care team, patients, information technology experts, and the research team. A steering committee with 3 working groups was established to oversee the technological, clinical, and evaluation aspects of this study. Recruitment of patients for ePROMs started in February 2024, and data collection is expected to continue until March 2025. Interviews with members of the cancer care team began in November 2024. Full analysis should be completed by September 2025. This study will clarify how, why, for whom, and under what conditions TM can complement current care models. Our evaluability assessment will help to address implementation complexities and better understand intervention-to-practice operationalization so that implementation might be adapted to contextual factors without potentially harmful or inequitable impacts on patients. DERR1-10.2196/63099.

Stressors contributing to burnout among acute care and trauma surgery care teams: a systems-analysis approach

BackgroundBurnout negatively impacts healthcare professionals’ well-being, leading to an increased risk of human errors and patient harm. There are limited assessments of burnout and associated stressors among acute care and...

Psychosocial Support Needs and Preferences Among Family Caregivers of ICU Patients with Severe Acute Brain Injury: A Qualitative Thematic Analysis.

Family caregivers of patients with severe acute brain injury (SABI) are at risk for clinically significant chronic emotional distress, including depression, anxiety, and posttraumatic stress. Existing psychosocial interventions for caregivers of intensive care unit (ICU) patients are not tailored to the unique needs of caregivers of patients with SABI, do not demonstrate long-term efficacy, and may increase caregiver burden. In this study, we explored the needs and preferences for psychosocial services among SABI caregivers to inform the development and adaptation of interventions to reduce their emotional distress during and after their relative's ICU admission. In this multicenter longitudinal qualitative study, we conducted semistructed interviews with SABI caregivers at two time points: during their relative's ICU admission (n = 30) and 2months later (n = 20). We analyzed qualitative data using a hybrid of inductive and deductive analytic techniques. We recruited family caregivers of patients with SABI from 14 US neuroscience ICUs. We conducted interviews over live video. Our convenience sample of SABI caregivers (n = 30) was recruited through referral by medical teams and nursing staffs across participating neuroscience ICUs. Caregivers included spouses, children, parents, and siblings to patients with SABI. We identified themes and subthemes related to participants' preferences for (1) the content of psychosocial support services and (2) the delivery and implementation of psychosocial support services. Findings revealed an unmet need for psychosocial support around the time of ICU discharge and 2months later, including information to understand their loved one's condition and guide difficult decision-making, education regarding how best to communicate with the patient's care team and other family members, and emotional and behavioral coping skills. Our findings provide specific recommendations to justify and inform the development and adaptation of psychosocial support services for SABI caregivers for delivery in the ICU and after discharge.

Perceptions of Clinical Connectedness Among Hospital Environmental Service Workers

Environmental service workers (ESWs) have a critical role within the hospital infrastructure and are at the frontline of infection prevention. ESWs are highly trained in managing all forms of regulated waste, which includes biohazardous waste, and are responsible for the overall patient experience, janitorial work, and infection prevention. Without environmental services, patients have a 6 times greater risk of being infected by pathogens from patients who previously occupied their room. To understand how ESWs felt proud, connected, and not connected to their hospital-based clinical teams. This qualitative study included 10 ESWs who were members of clinical care teams at a medical university hospital in upstate New York. Data were collected from February to May 2024. Participants were asked to take pictures and write vignettes about what makes them feel proud of their work, how they feel connected to their clinical team, and how they feel disconnected from their clinical team. This study included 10 participants (5 males [50%]; 10 non-Hispanic Black or African American individuals [100%]; mean [range] age, 53 [38-66] years; 8 were high school graduates or had some college credit [80%]). When asked about their feeling of pride, participants expressed maintaining a clean space, having meaningful relationships, and helping others as generating a sense of pride. Participants' feelings of disconnectedness were felt by their colleagues not following the rules set in place. In addition, participants reported feeling invisible, not listened to, unappreciated, and undervalued. Participants felt connected to their clinical teams by feeling a sense of community, having valuable relationships, and being able to communicate with members of the clinical team. Additionally, participants expressed a collective desire to be acknowledged, recognized, and treated as equals on the clinical team. The study found that ESWs identified feeling both connected to and disconnected from their clinical teams. Based on these results, hospital infrastructure and leadership should continue to exhaust all efforts to explore work experiences of ESWs to improve job retention, morale, satisfaction, overall clinical teamwork, and comradery.

Embedding Universal Language Promotion in Pediatric Primary Care to Optimize Early Child Development and Reduce Long-Term Health Disparities.

To report on the feasibility and outcomes of universal language promotion intervention (Talk With Me Baby [TWMB]) embedded within routine well-child care for children from birth to 3-years old. Across 2 primary care clinics, 29 health care team members participated in a 12-month trial to deliver TWMB within well-child care visits. Feasibility was based on clinician feedback during the trial, clinician knowledge assessments, and clinic data. Sixty-three parents and their infant/toddlers were enrolled to provide feedback on TWMB and to assess parent language promotion behaviors, specifically, parents' self-reported use of their language-building interactions during daily activities with their child. Clinician feedback and clinic data support TWMB as an acceptable and feasible intervention that can be used successfully within standard of care well-child visits by health care teams. Initial outcome data show positive changes for increasing parent-child language promoting interactions during daily activities. Results support the promise of leveraging primary care as a low-cost, scalable way to deliver universal language promotion intervention to optimize the developmental potential of all young children.

Pediatric Fever in the Emergency Department: Triage to Caregiver Education.

The number 1 reason children 15 years of age and younger present to the emergency department is fever. To successfully address this common chief complaint, a consistent message must be sent by all health care team members. This consistent message must demonstrate a solid knowledge of the physiology of fever, which includes the benefits of fever and the pattern of fever during an illness. In addition, treatment of fever must be evidence based with a goal of comfort rather than normothermia. Nurses must address caregivers' concerns and consider the age, medical history, and clinical presentation of the child with fever when determining the appropriate triage level and management.

Current Treatment Options for Diabetic Retinal Disease.

The global incidence of diabetes is rising steadily and with it the number of people living with diabetic retinal disease (DRD) is increasing. Like diabetes, DRD can be treated but not cured. In response, therapies to address DRD include targeted ocular and systemic medications. This review discusses diabetes and DRD in terms of current screening recommendations, treatments, and considerations related to those therapies and future drug targets and trials on the horizon. This discourse is targeted at all members of the diabetes care team, including primary care providers, optometrists, and ophthalmologists. The dynamic landscape of diabetic retinopathy treatment is promising for the prevention and improvement of visually significant disease.

Birthing parent and companion verbal reactions following interactions with inpatient postpartum health care team members: an observational study using naturalistic filming

BackgroundRespectful, equitable, and supportive health care team interactions with patients and their companions are a key part of quality health care services. Despite the importance of communication and other aspects of engagement during inpatient postpartum care, little is known about how care is experienced during this period from families’ perspectives.MethodsThis study collected video and audio data with 15 birthing families (n = 9 English-speaking and n = 6 Spanish-speaking) and their health care team members during inpatient postpartum care in a southeastern United States academic medical center. This analysis quantifies health care team member presence in family hospital rooms, assesses linguistic appropriateness of health care team member verbal communication, and describes birthing parent and companion verbal reactions to health care team member interactions. A behavioral taxonomy was applied to identify these codes in the 12 h prior to hospital discharge. Additionally, we transcribed the birthing parent and companion verbal reactions for 10-minutes each time the health care team member departed their room. This content was inductively coded to identify topics and develop themes.ResultsA total of 160 h of video and audio data were coded across 15 participating families for this analysis. There were 19.9 h of missing data in the 12 h prior to hospital discharge due to equipment being turned off across five participants. At least one health care team member was present in the postnatal unit rooms within the observation period in 200 instances (median 13 times, range 5 to 19 times per participating family). Communication with Spanish-speaking birthing parents was linguistically appropriate for between 20.0% and 75.0% of interactions. Following health care team member presence, birthing parent and companion reactions were indeterminate 1 time, no verbal reaction 107 times, positive 25 times, confused 38 times, and negative 52 times. Many parents expressed more than one reaction. Reaction topics included clarity of information provided, postpartum pain management, hospital discharge coordination, health care team member conduct, and access to supplies.ConclusionThere are strengths in postpartum patient engagement as well as areas for health care team improvement. More appropriate communication including setting of clearer expectations surrounding various aspects of services on the postnatal unit may improve patient experiences. As a part of this improved quality of inpatient postpartum care, consistent utilization of interpretation services could decrease patient confusion, enable shared decision-making, and promote positive patient-provider relationships.

Qualitative Study of Health Care Team Perception of the Benefits and Limitations of Remote Symptom Monitoring.

Remote symptom monitoring (RSM) using electronic patient-reported outcomes (ePROS) connects patients and health care teams between appointments. Patient-perceived benefits and drawbacks of RSM are well-known, but health care team members' perceptions are less clear. Health care team members from the University of Alabama at Birmingham and the University of South Alabama Health Mitchell Cancer Institute participated in semi-structured qualitative interviews to explore their experiences and perspectives on RSM benefits and limitations. Interviews were audio-recorded, transcribed, and analyzed inductively using NVivo software to identify recurring themes and exemplary quotes. Thirty oncology health care team members, including physicians (n = 9), nurse practitioners (n = 2), nurses (n = 8), nonclinical navigators (n = 7), and administrators (n = 4), were interviewed. Findings were organized into five major themes: three benefits (Proactive, Improved Patient-Health Care Team Relationship, and Patient Engagement and Symptom Reporting) and two limitations (Health Care Team-Perceived Limited Patient Buy-In or Awareness and Workload and Workflow Issues). Health care team members perceived that RSM improved their ability to support patients and the quality of care delivered to patients by promoting proactive management, strengthening the patient-health care team relationship, and engaging patients in symptom reporting. Despite positive perceptions, health care team members also voiced drawbacks of RSM related to the lack of patient buy-in or awareness and increased workload and disrupted workflow. Although health care team members recognized the benefits of RSM as a standard of care, future work is necessary to address identified limitations to support wide-scale implementation of RSM in oncology practices.

The mediating role of professional identity between work environment and caring behavior: a cross-sectional survey among hospice nurses in China

BackgroundAs core members of hospice care team, the hospice nurses’ ability to care for patients not only directly affects the standard of patient care, but also significantly impacts patient quality of life. It can be seen that it is very meaningful for patients to improve the caring behavior of hospice nurses. Therefore, it is necessary to deeply explore the influencing factors of nurses’ caring behavior and further clarify the mechanism between them.MethodsThe STROBE guideline was performed to report this study. We conducted a cross-sectional survey from December 2023 to February 2024. In this study, 392 hospice nurses were recruited from tertiary public hospitals in East China by convenient sampling method. Participants were investigated using the Practice Environment Scale, Professional Identity Scale, and Caring Behaviors Inventory. Structural equation modelling was utilized to verify the research hypotheses.ResultsThe results revealed that there were significant and positive correlations between work environment, professional identity and caring behavior. Furthermore, professional identity partially mediated the relationship between work environment and caring behavior.ConclusionWork environment is critical to improving hospice nurses’ caring behavior. Professional identity plays an intermediary role impacting how work environment promotes caring behavior among Chinese hospice nurses. Nursing managers should have a correct understanding of the relationship between them. Targeted measures and coping strategies need to be actively taken to create a better working environment for hospice nurses. This would enhance professional identity, and thereby promote caring behavior.

Patient assessment of the CAPE: A solution to negative pressure isolation in an emergency department

IntroductionThe Collapsible Aerosolized Particle Enclosure (CAPE) is a negative pressure patient isolation device designed to protect patients and clinicians from aerosolized infectious particles. The CAPE is intended to provide a safe environment for care receipt and delivery when isolation capacity is limited. The goal of this study was to evaluate the acceptability of receiving care in the CAPE from the emergency department (ED) patient perspective. MethodsFor this prospective, observational study, adult ED patients receiving care in the CAPE were asked to participate in an anonymous survey upon conclusion of the patient encounter. Survey domains included comfort, ability to see and communicate with care team members, space adequacy, perceptions of safety, and the ease of entering and exiting the device. Participants provided responses using a five-point Likert-type scale. ResultsTen adult patients participated during a 68-day evaluation period in a tertiary care ED. A total of seven completed the survey (70 %); the remaining three did not complete the survey due to illness severity. The median time spent in the device was 190 min. The median degree of comfort inside the CAPE was 5.0. Participants rated their ability to see their surroundings as median 5.0. The median score for ability to communicate with their medical team inside the CAPE was 5.0. Patients reported feeling safe inside the device with a median of 5.0 and most felt there was enough space inside with a median 5.0. The IQR for each of the above metrics was 5.0 and 5.0. Additionally participants also found it easy to mobilize in and out of the CAPE, with a median score of 5.0, IQR 4.0, 5.05. ConclusionsIn this pilot, prospective, observational study with adult ED patients, the majority of patients found the CAPE comfortable and safe, providing adequate space, and easily accessed. Use of the CAPE with ED patients was feasible and acceptable in our setting, supporting its use as a promising method for expanding isolation space during times of limited negative pressure capacity.

Making Community-Based Palliative Care Eligibility Determinations: Palliative Care Team Member Perspectives on Access to Information and Algorithm Use.

Seriously ill older adults have high risk of mortality, symptom burden, and compromised functional status, and may benefit from community-based palliative care ("palliative care"). However, identifying potentially eligible individuals is challenging. Identify how a palliative care team makes eligibility determinations, including the use of a mortality risk algorithm. Semi-structured focus groups were conducted with palliative care providers to understand how health information is used to assess Medicare Advantage plan patients' eligibility for palliative care. Transcripts were analyzed to identify categories related to how participants used health information in making eligibility determinations. All outreach and care management team members and nurse practitioners (n = 7) working for a palliative care program at a not-for-profit health care agency. The palliative care team used information on symptoms, diagnoses, and acute care utilization when making eligibility determinations. The algorithm generated lists of potentially eligible patients but was deemed not useful because it provided limited information about current health status and was not well integrated into existing health record systems. Participants would like information to be current, detailed, and presented in one location. Palliative care team members used a variety of indicators of unmet care needs to make eligibility determinations. A mortality risk algorithm to identify potentially eligible patients was insufficiently detailed to be useful in final eligibility determinations. These findings provide insights into how health data can be presented to better integrate health information from mortality risk algorithms into existing workflows to support palliative care eligibility decision making.

Development of a Diabetes Navigator Toolkit to Support Diabetes Technology Uptake: The IMPACT Toolkit

Advanced diabetes technologies (ADTs), including continuous glucose monitoring devices, insulin pumps, and automated insulin delivery systems, improve glycemic control in type 1 diabetes but are underutilized, particularly in minority and underserved populations. This article reports on a qualitative study to develop a diabetes toolkit. Participants identified barriers to the use of ADTs and proposed solutions to these barriers, which were then incorporated into a diabetes toolkit designed for use by a diabetes navigator or other diabetes care team members seeking to improve the uptake and sustained use of ADTs.

QOL-04. THE UNDER-UTILIZATION OF PALLIATIVE CARE SERVICES BY PATIENTS WITH GLIOBLASTOMA HIGHLIGHTS THE IMPORTANCE OF DISCUSSIONS AROUND PALLIATIVE CARE: A CROSS-SECTIONAL STUDY WITH CARE PARTNERS OF PATIENTS WITH GBM RECRUITED FROM FACEBOOK SUPPORT GROUPS

Abstract Glioblastoma (GBM) is a terminal brain cancer that has a rapid onset and results in symptoms such as headaches, vomiting, seizures, anxiety, depression, agitation, speech impairment, memory impairment, infections, brain bleeds, mobility changes, changes in sleep patterns, and cognitive changes. Palliative care helps patients diagnosed with an incurable or chronic disease manage physical, social, and psychological symptoms and has been shown to increase survival for patients with cancer. Previous data of former care partners of patients with GBM indicated only 30% of patients used palliative care whereas 90% used hospice. To better understand the reasons for underutilization of palliative care patients with GBM, 38-question survey about the use of palliative care, type of medical center where treatment occurred, and discussions with care team members about palliative care was given to current care partners recruited from Facebook support groups in February 2024. Inclusion criteria: current primary care partner of a patient with GBM, over the age of 18, and willing to participate (IRB exempt; H24-0393). The care partner was excluded if their patient was no longer living. Of the 77 current care partners, 56 reported they did not use palliative care as part of their care team. The use of palliative care was similar among care facilities (community hospital, major medical center, university hospital, brain tumor center). When care team members discussed palliative care with patients and their care partners (n=21), 71% of the dyads used palliative care. When care team members did not discuss palliative care (n=56), the use of palliative care was much lower at 7%. Interestingly, 55% of respondents reported they would benefit from knowing more about ways to increase physical and emotional support. This data suggests discussions around palliative care increase the use of palliative care services among patients with GBM and their care partners.

Measuring Patient Well-Being During Whole-Person Clinical Care: Lessons From the Veterans Health Administration Well-Beings Signs Implementation Pilot.

Measuring patient well-being during clinical care may enhance patient-centered communication and treatment planning. The Veterans Health Administration (VHA) piloted the use of the Well-Being Signs (WBS), a self-report measure of psychosocial well-being, in clinical care. To understand early WBS implementation and health care team member experiences with its use before developing detailed support materials and finalizing the measure. We conducted a mixed-methods evaluation of the WBS implementation pilot at 4 VHA facilities, including surveys of (n=4) Whole Health (WH) leaders/clinical leads, and semi-structured interviews with (n=11) clinical leads and team members. Survey data were characterized using descriptive statistics; interview data were analyzed using rapid qualitative analysis. Facilities supported WBS implementation by disseminating information to clinical team members, primarily during staff meetings (3/4 facilities), individual discussions (3/4), and email (3/4); only half provided training sessions. In interviews, some care team members expressed the need for more training on using the WBS in clinical care. Some interviewees also provided suggestions for changes to the draft measure, including response option format and question look-back period. Although there have been growing calls for attention to patient well-being in clinical care, our results suggest barriers to the implementation of well-being measures in this context. Findings were used to inform the development of enhanced training materials and make modifications to enhance the acceptability of the WBS to providers. Other identified barriers will need to be addressed in future implementation efforts, including bolstering leadership support and easing the added time and burden of administration.

Collecting sociodemographic data in primary care: Qualitative interviews in community health centers.

Many primary care organizations do not routinely collect sociodemographic data (SDD) such as race, gender, or income despite the importance of this data in addressing health disparities. To understand the experiences of primary care providers and staff in collecting SDD. A qualitative interview study with 33 primary care and interprofessional team members from eight Ontario Community Health Centres (CHCs). Semi-structured virtual interviews and content analysis of interview transcripts. Participants reported using both formal methods of SDD collection, and informal methods of SDD collection that were more organic, varied, and conducted over time. Participants discussed sometimes feeling uncomfortable collecting this data formally, as well as associated burden and limited resources to support collection. Client-provider rapport was noted as facilitating data collection and participants suggested more training, streamlined data collection, and better communication about purpose and use of data. SDD can be collected informally or formally but there are limitations to informally collected data and barriers to the adoption of formal processes.

Navigating Voluntarily Stopping Eating and Drinking in Hospice Settings: A Multidisciplinary Approach.

This article explores current global research on voluntarily stopping eating and drinking (VSED) and presents a detailed, deidentified case study of a patient who elected VSED in a hospice setting in the Southeastern United States. It highlights the collaborative efforts of health care professionals in effectively supporting the patient and family, sharing multiple perspectives from various health care team members who cared for the patient and family. It offers evidence-based recommendations to guide health care teams through the ethical, medical, and emotional challenges of VSED, ensuring compassionate and competent care. The article emphasizes the importance of structured protocols and empathetic care in hospice settings, advocating for the education and preparation of health care teams and families to address the complex challenges associated with VSED. By promoting open communication, interdisciplinary collaboration, and comprehensive support, hospices can respect the autonomy of patients and families choosing VSED, ensuring a compassionate and dignified end-of-life experience.