Document text
Principal Investigator: Jamie Treadway Nomitch
Organization: UNIVERSITY OF WASHINGTON
Fiscal Year: 2024
Award: $89,188
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY/ABSTRACT
Patients with chronic illness who develop acute respiratory failure face significant morbidity and mortality, with
survivors often suffering serious physical and psychological sequelae. These patients have a critical need for
palliative care. Palliative care is focused on improving quality of life for both patients and family of patients with
serious illness by providing high-quality communication, symptom control, and emotional and spiritual support.
Despite how important this type of care is, there is little information available regarding the quality of palliative
care provided to chronically ill patients with acute respiratory failure. Without this knowledge, it is extremely
challenging to develop effective interventions to enhance patient- and family-centered outcomes for this
population.
To fill this key knowledge gap, I will use explicitly defined, measurable items that detail the processes,
outcomes, and structure of palliative care to achieve my primary objective of examining temporal trends in
palliative care over the last decade, including an assessment of changes that have occurred since the
inception of the COVID-19 pandemic. I have identified a cohort of over 16,000 patients with chronic, life-limiting
illness hospitalized with acute respiratory failure between 2012 and 2022. Using this cohort, I will achieve my
primary objective through two specific aims. Aim 1 will examine temporal trends in quality indicators of
palliative care for patients with chronic illness hospitalized with acute respiratory failure between 2012-2022.
Aim 2 will assess differences in quality indicators of palliative care for patients with chronic illness hospitalized
with acute respiratory failure, comparing patients with COVID-19 to those without COVID-19, between 2020-
2022.
By accomplishing the proposed aims, I will identify improvement, stagnation, and decline in care over time in
specific process and outcome metrics across multiple palliative care domains, highlighting significant changes
occurring during the COVID-19 pandemic and identifying differences in quality indicators of palliative care for
those with and without COVID-19. Results from the proposed project will inform my future research to describe
mechanisms underlying these trends, with the goal of developing effective interventions to improve care
delivery for adults with chronic, life-limiting illness and acute respiratory failure.
Terms: <21+ years old><Acute respiratory failure><Adult><Adult Human><Airway failure><Analgesia Tests><Biostatistical Methods><COVID crisis><COVID epidemic><COVID infected patient><COVID pandemic><COVID patient><COVID positive patient><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 infected patient><COVID-19 pandemic><COVID-19 patient><COVID-19 period><COVID-19 positive patient><COVID-19 public health crisis><COVID-19 years><COVID19 patient><COVID19 positive patient><CV-19><Cancers><Caring><Chronic><Chronic Disease><Chronic Illness><Chronically Ill><Clinical><Communication><Consensus><Consultations><Coronavirus Infectious Disease 2019><Data><Electronic Health Record><Emotional><Epidemiologic Methods><Epidemiological Methods><Epidemiological Techniques><Evolution><Face><Family><Family member><Funding><Goals><Health Care Systems><Healthcare Systems><Home><Hospital Admission><Hospital Mortality><Hospitalization><Hospitals><In-house Mortalities><Inhospital Mortality><Intervention><Intervention Strategies><Investigators><Knowledge><Life><Malignant Neoplasms><Malignant Tumor><Measurable><Mechanical ventilation><Mentors><Mentorship><Methods Epidemiology><Morbidity><Morbidity - disease rate><NHLBI><NIH><National Heart, Lung, and Blood Institute><National Institutes of Health><Nociception Tests><Outcome><Outcomes Research><Pain Assessment><Pain Measurement><Pain measure><Palliative Care><Palliative Therapy><Palliative Treatment><Patient Care><Patient Care Delivery><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Pattern><Physicians><Population><Process><Publications><QOL><Quality Indicator><Quality of life><Records><Research><Research Personnel><Researchers><Respiratory Failure><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 infected patient><SARS-CoV-2 pandemic><SARS-CoV-2 patient><SARS-CoV-2 positive patient><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Scientific Publication><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Specialty><Spirituality><Stress><Structure><Survivors><Symptoms><Temporal trend><Time><Time trend><Trends over time><United States><United States National Institutes of Health><adulthood><care delivery><care for patients><care of patients><care outcomes><caring for patients><chronic disorder><cohort><comfort care><consultation><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 infected patient><coronavirus disease 2019 pandemic><coronavirus disease 2019 patient><coronavirus disease 2019 positive patient><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease infected patient><coronavirus disease pandemic><coronavirus disease patient><coronavirus disease positive patient><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus disease-19 patient><coronavirus infectious disease-19><coronavirus patient><current pandemic><data driven platform><data platform><death risk><effective intervention><electronic health care record><electronic health medical record><electronic health plan record><electronic health registry><electronic medical health record><end of life care><experience><faces><facial><health care outcomes><healthcare outcomes><high risk><homes><hospital re-admission><hospital readmission><improved><intervention design><interventional strategy><malignancy><mechanical respiratory assist><mechanically ventilated><medical specialties><mortality><mortality risk><neoplasm/cancer><pain assay><pandemic><pandemic disease><patient infected with COVID><patient infected with COVID-19><patient infected with SARS-CoV-2><patient infected with coronavirus disease><patient infected with coronavirus disease 2019><patient infected with severe acute respiratory syndrome coronavirus 2><patient oriented outcomes><patient population><patient with COVID><patient with COVID-19><patient with COVID19><patient with SARS-CoV-2><patient with coronavirus disease><patient with coronavirus disease 2019><patient with severe acute respiratory distress syndrome coronavirus 2><physical symptom><post-pandemic><pre-pandemic><present pandemic><primary outcome><psychologic><psychological><re-admission><re-hospitalization><readmission><rehospitalization><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><severe acute respiratory syndrome coronavirus 2 infected patient><severe acute respiratory syndrome coronavirus 2 patient><severe acute respiratory syndrome coronavirus 2 positive patient><skill acquisition><skill development><therapy design><treatment design><trend>