Kate Courtright
speaker
701 appearances
3 recordings
1 series
first heard Jun 2022
last heard Mar 2024
Kate Courtright’s voice in public audio — every appearance, attributed to the second.
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It was done in ten hospitals, seventeen ICUs and atrium health.
Yeah, down in North Carolina.
Thirty five hundred.
Uh it depends.
So the uh asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I'll get into.
Um asking clinicians um whether they had offered the option of withdrawal of life support and comfort focused care.
also did not um change length of stay, but did increase the discharges to hospice odds greater than twofold, whether it was done alone or in combination with the prognostication nudge.
And um the same nudge, the withdrawal of life support nudge, also uh decreased the time to comfort care orders.
But importantly,
It did not change the frequency of comfort care orders.
It did not change the frequency of palliative care consultation, the timing of such or um ICU mortality or six month mortality.
Huh.
To me, it suggests that um that nudge helped clinicians identify and discuss earlier likely prognosis and goals and values, such that patients who were likely to go on and die in the ICU with comfort care did so earlier in their stay.
But more patients didn't die.
Patients who would go on to survive likely didn't die because the mortality curves all converged.
No, that was in Ascension Health and it was hospitalized patients who may have been in the ICU.
This was ICU only.
Um, I think the main one for me being asked on the fly is that um one of them nudged specialist palliative care consultation, which we know has limitations, right?
In that trial, not all of the consults that were accepted were actually able to be seen because of resource constraints.
In this Ponder ICU trial, we didn't rely on palliative care specialists.
Showing 61–80 of 701 · page 4 of 36
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