Table 2 Processes of care documented in decedents (n = 79) who did versus did not receive a palliative approach to care
Variables documented in electronic medical record | Overall (n = 79), n (%) | Did the patient receive a palliative approach to care? | P-valueab | |
|---|---|---|---|---|
Yes (N = 20), n (%) | No (N = 59), n (%) | |||
Mortality Acknowledgement | ||||
 Advance Care Planning topics addressed and documented: | ||||
  Goals of care for treatment decisions (to pursue a treatment or not and why) | 42 (53.2) | 18 (90) | 24 (40.7) |  < .01 |
  Understanding of severity of illness (illness awareness) | 32 (40.5) | 17 (85) | 15 (25.4) |  < .01 |
  Values/beliefs/priorities moving forward | 26 (32.9) | 18 (90) | 8 (13.6) |  < .01 |
  Do-Not-Resuscitate & Do-Not-Resuscitate Confirmation Form | 20 (25.3) | 15 (75) | 5 (8.5) |  < .01 |
  Power of Attorney for Personal Care & Substitute Decision Makers | 18 (22.8) | 9 (45) | 9 (15.3) | .01 |
  Desired place of death | 13 (16.5) | 11 (55) | 2 (3.4) |  < .01 |
  Prognosis | 11 (13.9) | 11 (55) | 0 (0) |  < .01 |
  Will | 2 (2.5) | 2 (10) | 0 (0) | .06 |
  Funeral arrangements | 2 (2.5) | 2 (10) | 0 (0) | .06 |
  Other | 5 (6.3) | 2 (10) | 3 (5.1) | .60 |
Quality of Life | ||||
 Homecare involvement documented: | ||||
  Nurse | 32 (40.5) | 17 (85) | 15 (25.4) |  < .01 |
  Personal Support Worker | 22 (27.8) | 10 (50) | 12 (20.3) | .01 |
  Occupational Therapist | 8 (10.1) | 5 (25) | 3 (5.1) | .02 |
  Physiotherapist | 4 (5.1) | 2 (10) | 2 (3.4) | .26 |
  Psychosocial/Spiritual Advisor | 3 (3.8) | 3 (15) | 0 (0) | .01 |
  Registered Dietitian | 2 (2.5) | 1 (5) | 1 (1.17) | .38 |
  Other | 12 (15.2) | 1 (5) | 11 (18.6) | .28 |
Quality of Life focused symptom discussions documented: | ||||
  Physical Symptoms | 71 (89.9) | 19 (95) | 52 (88.1) | .67 |
  Delirium | 8 (10.1) | 8 (40) | 0 (0) |  < .01 |
  Symptom Assessment Tools used | 5 (6.3) | 2 (10) | 3 (5.1) | .60 |
  Other | 1 (1.3) | 1 (5) | 0 (0) | .25 |
Whole-person Care | ||||
 Primary care involvement documented: | ||||
  Most Responsible Physician | 68 (86.1) | 20 (100) | 48 (81.4) | .06 |
  Medical Resident | 59 (74.7) | 18 (90) | 41 (69.5) | .08 |
  Nurse | 35 (44.3) | 14 (70) | 21 (35.6) | .007 |
  Pharmacist | 17 (21.5) | 4 (20) | 13 (22.0) | 1.00 |
  Occupational Therapist | 10 (12.7) | 1 (5) | 9 (15.3) | .44 |
  Registered Dietitian | 5 (6.3) | 0 (0) | 5 (8.5) | .32 |
  Physiotherapist | 2 (2.5) | 0 (0) | 2 (3.4) | 1.00 |
  Social Worker | 1 (1.3) | 1 (5) | 0 (0) | .25 |
  Other | 23 (29.1) | 5 (25) | 18 (30.5) | .64 |
 Caregiver involvement and status documented: | ||||
  Caregiver presence documented | 47 (59.5) | 18 (90.0) | 29 (49.2) | .01 |
  Caregiver concerns documented | 39 (49.4) | 18 (90.0) | 21 (35.6) |  < .01 |
  Caregiver well-being documented | 12 (15.2) | 9 (45.0) | 3 (5.1) |  < .01 |
 Whole-person care focused symptom discussions documented: | ||||
  Existential/psychosocial/spiritual concerns | 33 (41.8) | 16 (80) | 17 (28.8) |  < .01 |
  Safety concerns | 26 (32.9) | 11 (55) | 15 (25.4) | .02 |
  Financial concerns | 17 (21.5) | 7 (35) | 10 (16.9) | .11 |
  Cultural concerns | 1 (1.3) | 0 (0) | 1 (1.7) | 1.00 |
 Phone care documented as ‘Often’ (5 or more phone calls)d | 33 (43.4) | 15 (75) | 18 (32.1) |  < .01 |
 Documented number of home visits in final year of life, mean (SD) | 2.3 (7.1) | 4.0 (5.1) | 1.7 (7.6) | .21c |