A5013786876- Palliative Care and End-of-Life Issues
- Childhood Cancer Survivors' Quality of Life
- Cancer survivorship and care
- Family and Patient Care in Intensive Care Units
- Patient-Provider Communication in Healthcare
- Intensive Care Unit Cognitive Disorders
- Patient Dignity and Privacy
- Pharmacological Effects and Toxicity Studies
- Epilepsy research and treatment
- Mobile Health and mHealth Applications
- Digital Mental Health Interventions
- Healthcare Decision-Making and Restraints
- Economic and Financial Impacts of Cancer
- Geriatric Care and Nursing Homes
- Pain Management and Opioid Use
- Homelessness and Social Issues
- Robotic Mechanisms and Dynamics
- Grief, Bereavement, and Mental Health
- Complementary and Alternative Medicine Studies
- Anesthesia and Pain Management
- Psychedelics and Drug Studies
- Robotic Path Planning Algorithms
- Control and Dynamics of Mobile Robots
- Interprofessional Education and Collaboration
- Ethics in medical practice
University of California, Los Angeles
2015-2024
UCLA Health
2017-2024
University of California San Francisco Medical Center
2017
Los Angeles Medical Center
2017
Georgetown University
2017
Campbell University
2016
RAND Corporation
2016
University of California, San Francisco
2015
Clark University
2013
Integrating palliative care into intensive units (ICUs) requires involvement of bedside nurses, who report inadequate education in care.To implement and evaluate a professional development program for ICU nurses.From May 2013 to January 2015, advanced practice nurses nurse educators 5 academic medical centers completed 3-day train-the-trainer followed by 2 years mentoring the initiative. The consisted 8-hour communication workshops structured rounds ICUs, where leaders coached identifying...
To test a simultaneous care model for palliative patients with advanced cancer by embedding nurse practitioner (NP) in an oncology clinic.We evaluated the effect of intervention two oncologists' clinics beginning March 2014 using implementation strategies, including use structured referral mechanism, routine symptom screening, integration psychology-based supportive center, team meetings, training, and metrics dashboard continuous quality improvement. After 1 year implementation, we key...
Our case describes the efforts of team members drawn from oncology, palliative care, supportive and primary care to assist a woman with advanced cancer in accepting for her psychosocial distress, integrating prognostic information so that she could share decisions about treatment planning, involving family ultimately transitioning hospice. Team our setting included medical oncologist, oncology nurse practitioner, social worker, physician. The core were patient sister. grew organically as...
Uncontrolled pain is one of the most feared and debilitating symptoms among cancer patients, many suffer unnecessarily from suboptimal control. Cancer-related often multidimensional can affect all aspects a patient's life. Hence, achieving adequate relief patients involves proper assessment psychosocial, spiritual, physical issues, matched with an individualized treatment plan involving pharmacologic, nonpharmacologic, procedural therapies when appropriate. Providing effective help ease...
Although palliative care is recognized as an important component of medical school curricula, the content and structure education in field variable often lacks outpatient exposure. We aimed to develop implement a clinical elective for fourth-year students incorporating both inpatient learning.Fourteen participated which included 2 weeks on consult service 1 week clinic home hospice visits. The was evaluated using focus group previously validated surveys assessing self-rated competency...
Open design formats for mobile apps help clinicians and stakeholders bring their needs to direct, co-creative solutions. Palliative care patients with advanced cancers requires intensive monitoring support remains an area in high need innovation.This study aims use community-partnered participatory research co-design pretest a app that focuses on palliative priorities of cancer.In-person teleconference workshops were held patient family stakeholders, researchers, oncology. Question prompts,...
Guidelines support early integration of palliative care (PC) into standard oncology practice; however, little is known as to whether outcomes can be improved by modifying health delivery in a real-world setting.We report our 6-year experience embedding nurse practitioner an clinic (March 2014-March 2020) integrate early, concurrent advance planning and PC.Compared with patients advanced cancer not enrolled the program, March 2020, who are more likely have higher quality PC (eg, goals note...
Advance Care Planning for the Homeless: A Community Collaboration Delia M. Cortez, Kylee Harding, Lori Koutouratsas, Christopher Pietras, and Jeannette Meyer UCLA Medical Center, Santa Monica is an academic medical center that serves a large homeless patient population, many of whom have chronic potentially life–limiting illnesses. Our emergency room sees approximately 50 patients during average 30–day period. Given transitory patterns this population as well complex needs, their healthcare...
96 Background: Physical and emotional symptoms are highly prevalent in patients with advanced cancers contribute to overall distress level decreased self-reported quality of life. Oncology organizations accrediting bodies now routinely recommend universal screening among cancers. Palliative supportive care clinicians play an important role implementing symptom cancer centers. Methods: As part embedded palliative nurse practitioner (PC-NP) intervention within a large ambulatory oncology...
Introduction: Learning expert communication skills is a core educational goal within palliative care training, yet there are few communication-based tools specifically designed for specialty-trained providers. Objective: To develop and implement tool to facilitate effective learning of serious illness hospice medicine fellows. Methods: A novel formative assessment was developed the UCLA Palliative Care Fellowship program, utilized throughout academic year on weekly basis. Focus groups were...
Providing patient care at the end of a patient's life is humbling and sacred experience for both provider. Without truthful meaningful conversation about end-of-life preferences, that delivered may not be prefers.Determine if there relationship between level training, confidence, presence decisional conflict in making an accurate prognosis 2 standardized cases. Additionally, we evaluated correctness as measured against survival outcomes patients with similar diagnoses.Decisional was SURE...
146 Background: We embedded a palliative nurse practitioner in 2 oncologists’ clinics March 2014 using reproducible training program. After one year, patients with advanced cancer receiving care the model clinics, compared to other were more likely have advance planning performed and die hospice. In order expand intervention oncologists, we evaluated efficiency our of delivery. Methods: reviewed overall caseload subset patient encounters depth understand how much NP's practice could be...
105 Background: We aimed to engage oncologists disseminate a successful pilot-tested shared mental model (SMM) for the integration of early advance care planning (ACP) and identification palliative (PC) needs across health system’s oncologic practice. Methods: Our Oncology Communication Collaborative Team (OCCT) had oncology leadership support included multidisciplinary team representing leaders in oncology, ACP, PC, psycho-social quality. To communicate SMM developed by our team, OCCT an...
163 Background: We initiated a nurse practitioner (NP)-based model of palliative care delivery embedded within an oncology clinic guided by shared mental (SMM) between care, oncology, and psychosocial clinicians in order to foster best practice collaboration closed-loop communication teams. These data represent processes outcomes three years after initial implementation the program. Methods: evaluated program growth as well advance planning, hospice use, utilization patients with advanced...
58 Background: American Society of Clinical Oncology guidelines support early integration palliative care (PC) into standard oncology practice; however, little is known as to whether improved outcomes can be achieved by modifying health delivery and training providers. Methods: We report our five year experience embedding a nurse practitioner (NP) in an clinic (March 2014-March 2019) develop shared mental model (SMM) early, concurrent advance planning (ACP) PC well the collaborative effort...