Vitas Healthcare is a hospice organization that provides the best healthcare for patientswith terminalillnesses. The organization provides care to patients at home, nursing home, assisted living, and inpatient unit. The interdisciplinary team is there to provide care and support to patients and their families(Vitas Healthcare, 2018). From the high standard services that are being provided by the organization, there have been some patients that required more care from Vitas. Therefore, the organization is forced to find some units in other buildings to offer the services to those patients. The big problem with the inpatient units or contract beds is that the landlord can decide to cancel or not to renew their contracts with Vitas at any time. Therefore, the organization will need to look someplace else for another unit. In the meantime, those patients that required a high level of care will not get the care they need. The other issue with not having a hospice house is that the landlord does not provide all the necessary equipment or utilities, and appropriate environment required to care for those patients. A hospice house will be the ideal place to care for those patients who requireda high level of care and support their families.
The clinical problem that identifies at Vitas is the care provided at the end of life in a contract bed facility is not the best care that the organization would have provided if they have their own hospice house. Patients in the contracted beds are not cared for by nurses with adequate training to provide end-of-life care. The nursing staff in the facilities do not receive adequate education to meet the needs of hospice patients. There is a lack of understanding of end-of-life medication administration and providing comfort care as opposed to acute care. Patients are receiving care from other nursing staff who are not trained to provide end of care. Those patients are in a contract bed; therefore, the company has no choice but to let that contracted facility provide care to those patients even though the care provided does not meet Vitas standards. Patients that are in the contract beds are required high doses of pain medication and anxiety medications to keep them comfortable.The contract facility is resistant to giving the medications that those patients required because they are not trained properly as hospice caregivers. They do not understand the purpose of administering those medications to keep those patients comfortable at the end of their life.
The description of the problem is patients admitted to contracted beds do not receive the support and care provided by Vitas employees. The contracted facilities do not have resources to provide the emotional, spiritual, and physical care to support end-of-life care. Patients and families are not satisfied with the care they receive in contracted beds, impacting CAHPS scores, which will impact reimbursement soon if it has not already occurred. At the end of life, the care includes family support; there is a big issue with the support that Vitas provided to those patients and their families. Sometimes, those patients’ families have requested a social worker or a chaplain to come to the facility for support, there have been several times that Vitas failed to provide those services due to staff availability. Vitas has to find a chaplain or social worker that have credentials to enter the contract facilities. If the staff that has credentials to go to those facilities are off, Vitas will not be able to provide the support that those families requested or needed. This is a big failure from the organization, which will affect their CAHPS scores and their reputation. This problem at Vitas needs to be fixed.
There are several challenges that come along with the poor setting in the contract facilities. The unit is very small, patients’ rooms are small, not enough space for patients’ family members and staff. Most of the time, the patients have a lot of family members, the unit has no space to hold all of those people. Because of the space issue, the families usually have to file a grievance form to report their concerns and their bad experiences.This is an indication that facility acquired has to be designed in a specific way. The appropriate environmentfor those patients and families requires a lot of funds. Although most of the patients are covered by the Medicare, Medicaid, and Vitas accepts a lot of charity patients, the cost of acquiring and maintaining the proper hospice house tends to weigh heavily on the organization. As a result, the rented units end up with less than the standard services being provided to those patients and their families.The goals and values of the organization are to provide comfort care and an appropriate environmentfor the patients and families.
The main cause of the problem identified is the care provided to those patients in the contracted beds. The company failed to provide the hospice care that those patients and their families were hoping for because Vitas does not have control over the care provided by the contracted facilities. If Vitas can go to those contracted facilities, administer medications to those patients, and support them as appropriate and as needed, the care those patients will receive will be the best quality care. Those patients’ families will be at peace that they know the company provide the best care to their loved ones at the end of life. Another cause is that Vitas does not have enough beds in those contract facilities to support the end of life population. Most of the time Vitas lose patients to their competitors because they do not have beds. Vitas has patients that are in the hospital and need to be on comfort care only, but Vitas has no beds available for those patients. They died in the hospital because Vitas did not have beds.
Most patients that tend to receive carein the hospice inpatient unitor a contract facility have a few months or days to live. Provision of appropriate medical care, as well as spiritual, emotional, and social life is essential.Another main cause of the problem is the cost of building a hospice house. The organization does not have sufficient funds to build the hospice house. Another cause is the state requirements to build the hospice house. The organization may not want to go through all those issues with the government; it is easier to rent some rooms in a facility to provide care to those patients. Out of the efforts, the facility will meet its main objective of providing care appropriately. Most of those patients need an appropriate environment at the end of their last days to be comfortable, also with families at the bedside holding their hands. This can be achieved through proper medication and availability of the other social prospects.
There are few organizations venturing into the provision of the appropriate hospice services. As a result, there is a need to overstretch the limited specialized condition to reach out to the individuals. The present facilities cannot be overloaded with patients.Therefore, there is a need to open a hospice house or more units for accommodation reasons. In most cases, the process of building a hospice house that is well-fitted with all the resources required to care for patients at the end of life may be long and time-consuming. Another factor that has led to the development of the value of the hospice housing is the social reason. The family of the patients may frequentlyvisit and at the same time. Furthermore, it would be almost impossible to get all those families at the unit at the same time.
The essential stakeholders are the patients and their family members, nurses, physicians, managers, administrators, and the general managers. The patientsare usually under the care of the nurses as well as the hospice physicians. Therapists and religious personnel such as chaplain or priests may also be required. Each department is expected to have a well-organized management team that will ensure the coordination of all the stated stakeholders. The power, interests, and the influence of all the stakeholders will be discussed in details below. Through their proper adhering to their responsibilities, the whole project can be said to be successful.
The nurses will have interest in the hospice house because they will be able to provide the best quality care to their patients. The nurses also have the power to advocate for their patients and fulfill their wishes. The nurses will impact every patient and family with their quality of care because they know they will be able to provide the best care to their patients at the hospice house. The nurses will have influence on the project by providing their ideas and suggestions on the structure of the plan and the implementation of the project. The physicians will have the power to order the right medications and doses to their patients to keep them comfortable at the end of their lives. They will be interested in the environment that the hospice house will bring to their patients such as peace and comfort. The physicians will have control over the patients’ medications, he/she will be able to make changes as needed. They will also be able to meet with the family members to discuss the patient’s plan of care, which will be a great influence on the patients and their families. The managers and the administrators have interest in the care that the staff will be able to provide to their patients. They must manage the influence of all stakeholders in relation to the project requirements to ensure a great outcome. The influence that the managers and the administrators will have with this project is their relationship with all the stakeholders to ensure successful delivery of project outcomes. They will have the power to provide the resources and the equipment needed at the hospice house to provide the best quality care possible. They will be there for the staff to provide support and to help them with any new changes implementation. They will be a great resource for the staff. The patients and family members will have a great interest in the hospice house because they know they will receive the best quality care. They will have the power to give suggestions and feedback to the management team regarding the care they receive. They also have power when they complete their surveys to determine if Vitas needs to get reimbursed for the care provided. They will be part of the decision maker for their loved ones, that will impact their lives.
The nurses, physicians, managers, therapists, and the chaplain or priests will meet to discuss the importance of opening the hospice house. They will put together a plan, and the issues involved in the unit, they will present them to the administrators and the general managers. They will work together to come up with a final decision. The nurses, the physicians, and the managers are the essential stakeholders to describe all the issues in the unit to the other stakeholders. They are providing care and interacting with the patients and their families most of the time. The administrators and the general managers are the ones that will bring the final decision or project to the organization management team, and they will bring feedback to the other stakeholders after their meeting with the organization team.
The purpose of this project is to provide a superior quality of care to the healthcare service users by developing an appropriate plan for the Hospice house. The plan will help the management to develop a Hospice House where the service user will be able to obtain palliative care with their family at their bedside. At the hospice house, Vitas will provide intensive palliative care focuses on pain relief, agitation and anxiety management, control terminal restlessness, and other symptoms management associated with terminal illness. Another purpose of the hospice house will be to provide respite care for the exhausted caregivers or family members. . Respite care will usually last till five days to relieve the stress and exhaustion on the caregivers that cared for their loved ones 24 hours a day and seven days a week at the end of life. Besides that this report has also been designed to provide exceptional care to the healthcare service users who are availing Hospice treatment with the help of trained staffs. It is crucial for the Vitas healthcare home to accumulate their patients at one place in order to ensure that best care has been provided to the healthcare service users.
Considering the fact that the patients are the chief subject as well as consumers of the Hospice house, the chief goal of the hospice house is to provide highly comfortable service to them during their last surviving days. Their feedback is much valuable for the future of the organization. Patients are the major provider of the finances that are going to use to implement the whole project. Together with the family members, patients are the final decision makers conserving their stay in the facility. Satisfaction of the patient will not only enhance the revenue of Vitas Healthcare Home but will also enhance its reputation. Considering the fact that the health care professionals and health care service users are the individual whose service impose most prominent impact on the patients, lack of proper service will result in dissatisfaction of the patients. In order to eradicate the issue, proper training as well as education should be provided to the nurses to enhance their nursing as well as communicational skills with the patients.
The involvement of the government will work to ensure that the services offered to the patients are by the regulations given out in the constitution. For instance, in the case where the individual is to sign informed consent documents, all the laws, both the state as well as federal laws have to be considered. No patients should be exposed to medication that has been prohibited by the state or federal government. Furthermore, the public comes in to ensure that the social factor of the patient has been put into consideration. With a government order, the whole facility can be shut down; especially, if it has been found to be incompetent. The management team can formulate some policies that are beneficial to the patients and their families. For instance, Vitas has a program called Hospice can help, it used to assist families in decision making (The Health Collaborative, 2017). Their main interest is to ensure that the all the section of the organization is functioning properly. The department has the power to change the internal laws that govern the operation of the hospice facilitiesas long as they are within the required limits by the government.
The main purpose of this project is to provide a better environment for the hospice patients and their families. Hospice is caring for patients at the end of their lives; they deserve to be in a nice and comfortable environment at the end of their lives. Therefore, a hospice house is essential to Vitas Healthcare to provide the best quality care to their patients and their families. A hospice house will improve the care for patients at the end of life for all the members of Central Florida. The objective of the hospicecare at Vitas cannot be met in the situation where the adequate value of the houses lacks. Another reason why the hospice house will be a great value to Vitas is the reputation of the organization. Vitas has been growing in central Florida, the need for the hospice house is critical. The design will pay attention to the patients, their families, employees of Vitas, and the government regulations. Furthermore, the component of finances will be greatly considered.
The proposed solution for this problem is to open a hospice house and transfer all hospice patients to one unit where they can receive care by Vitas staff. A proposal will be created to locate a facility or a hospice wing to put all hospice patients together. All staff will be trained the same way on how to care for those patients at the end of life. It is crucial for the organization to have access to their patients and provide care to them based on their standards. Vitas will have control over the care those patients receive. Vitas staff will be able to administer medications to their patients; they will be able to provide the best care to their patients. Vitas will have their trained staff working at the hospice house to provide quality care to their patients; this will help the organization CAHPS scores, and the organization reputation. At the hospice house, patients and families will have a beautiful, quiet, and peaceful environment. The families can spend time with their loved ones at the end of their lives. The organization will have excellent outcomes and patients’ satisfaction. Vitas needs to provide better care to their patients by having a hospice house where they can provide the best quality care based on their standards. Those patients and their families trust Vitas to provide the best care for their loved ones at the end of their lives. Therefore, the organization needs to deliver the care that those patients deserve.
The proposed solution for the project is to conduct fundraising events, get patients and families feedback on the project, and check with the state for any requirements to open a hospice house.The main challenge the organization is facing is not having enough fund to open the hospice house.Instead of renting units from nursing facilities or hospitals that do not provide a great environment, the organization needs to make a plan on opening a hospice house that has all the required resources and a peaceful environment to provide the best quality care to those patients that are dying. Instead of renting three or four units, the organization needs to open a hospice house with a minimum of 20-30 beds. The number of the hospice beds constructed should depend on the available resources and number of the patients expected to be served. The administrators and the general managers should take the project to the corporate board to get it approved. They have to show them all the important reasons why a hospice house is important at this time. For instance, they need to bring up all the issues that they are having in the units such as small space for patients and families, delay with the facilities responding on time to our concerns and issues, and failure to fix minor issues on the unit. Use of evidence-based research will show that a hospice house improves patients and families satisfaction, and provide better care in a better environment at the end of life.
The approach that is suggested in this report has been compiled to formulate a solution that aims at reducing patients from being admitted to a contracted hospice facility. With the understanding that these patients are in need of continuous and appropriate care as stated by Hudak, Helm, and White (2017). However, from the research by Wang (2016), there is clear evidence that home care for patients at the end-of-life is the most expensive. Therefore, a hospice house is the best place to care for patients with symptoms and families that need respite care. The scholars reported that the family caregivers lack the confidence to offer their services to their loved ones at home (Jack, 2016). The main reason for the failure was that they require training of the care involved. Therefore, by understanding the predicament, it is easy to train the family members and teach the confidence necessary at the hospice house while providing care to the patients. The approach will ensure that the patients receive constant attention. Furthermore, the hospice house will provide a chance to observe the progress of the patient at a glance and easily offer appropriate medication and transition to home.
The approach is aimed at reducing hospital visits. Given that the transfer of patients from the contracted facilities to home care, there is a need for close and keen caring (Shalev, 2017). It is always easier to transition patients from a hospice house to home than transfer from a contracted facility to home. In the hospice house, the hospice staff will educate the family how to care for their loved ones at the end of life because they are trained professionals. In a contract facility, the team is not trained correctly to educate families how to care for their loved ones at the end of life. At the hospice house, the caregiver will concentrate on a single individual, and maximum care will be offered. Throughout the project, all the activities that are involved are aimed at ensuring Vitas is able to provide the quality care to their patients in a hospice house, not in a contracted facility. The results of the method have proven to be beneficial from a study report by Jack (2014). Application of the same approach is to be applied to the plan provided in this document.
Based on the five articles, they talk about provided high-quality care to hospice patients at the end of life. The main subject of this project is to provide high-quality care to the patients at the end of life. Vitas also has some pediatric patients in contract bed facilities, those patients and families have a terrible experience with the contract facilities and the care they receive. It is essential for parents to know that their children are getting the best quality care at the end of their lives. It is already hard on the parents losing their children.They do not need to worry about the care that their kids are receiving. Those parents trust Vitas to provide their kids the best care.Therefore, Vitas needs to honor the parents’ wishes. This is the reason why the hospice house will be the best place to provide care to patients at the end of life. Evidence-based research shows that patients that are dying need to be in a peaceful environment, families at the bedside, and staff to support. Therefore, a hospice house is the ideal place for those patients.
It is vital that the patients get appropriate and continuous care(Simpser & Hudak, 2017). This can turn out to be more effective while at home than in the less equipped hospice setup. However, among the systems of hospice care, the most expensive is the continuous home care (Wang, 2016). To reduce the costsignificantly, the project will incorporate technology into the system (Anastasio, 2015). The approach is aimed at reducing hospital visits. Given that the transfer of patients from the facilities to home care, there is a need for close and keen caring(Shalev, 2017). Throughout the project, all the activities that are involved are aimed at ensuring that the affordability of the services for families(Kruschke, 2018). Use of evidence-based research will show that a hospice house improves patients and families satisfaction, and provide better care in a better environment at the end of life.
The steps that need to be taken to implement this project are the following:
The first step will involve holding a meeting with the managers of the mentioned healthcare home in order to discuss the project implementation. A meeting will be scheduled for a week with the corporate pharmacist, the general manager, the administrator, some nurses, and some managers to present the proposed solution. Secondly, in order to understand the importance of hospice house in healthcare home, a literature review will be conducted a secondary source of information. A total number of 8 articles will be reviewed. Amongst the 8 articles, literature review of 3 articles will be conducted in order to formulate a solution that aims at reducing patients from being admitted to a contracted hospice facility. According to researchers, healthcare opportunities are much expensive for patients who need palliative care compared to patients with general diseases. In order to develop effective solution of the mentioned issue, literature review of 2 article will be conducted. Finally, 3 articles will be analyzed to find out both the positive as well as negative impact of Hospice on the healthcare service users as well as on their families. The time that will be required for reviewing relevant literature is 3 weeks. The third step will involve hiring of vendors and contractors, ordering equipment, and holding hiring events.
After gathering data from the literature review a meeting will be conducted with the stakeholders in order to develop an appropriate plan for the project. We will go over the proposed solution and start planning the steps to take to open the hospice house. After this meeting, we should be able to start working on the steps to open the hospice house by hiring vendors and contractors, ordering equipment, and holding hiring events. The stakeholders will go to the community to present the project to the population and handing flyers to the community. When the stakeholders meet to discuss the plan, they will give their support and commitments to the project. They will discuss the development of the plan, for instance, hired a contracted pharmacist to restock the pyxis and to make sure that we comply with the state regulations. There will be several meetings held after the opening to discuss the progress, and make any changes to the plan as needed. Job fairs are being held every two weeks to hire staff for the hospice house.There will be a presentation to inform the stakeholders about the development of the project and the changes to the plan.
The first step that needs to be taken is to get the approval letter for the organization corporate department. Then the management team will meet to go over the plan and make a list of things that will be needed to start the process. All the employees that will be working on the project will need to be trained. The stakeholders will need to meet regularly to discuss the plan and make changes to the plan as needed. All the equipment that will be needed in the new hospice house will be ordered, and the employees will be trained on all new equipment. The management team will contact all the vendors and meet with them to go over the project and the plan.The management team should work on deciding and coming up with a site that will be appropriate for the equipped facility. Appropriate equipment should be installed and tested before using them on patients for safety. The team will often be meeting to go over the changes and present all other required equipment that was not on the project to the corporate team for approval.
The first week will be needed for conducting literature review ad gathering secondary data that will facilitate us to plan the project. Within the first week, reviewing 8 literatures relevant to the mentioned topic will be performed and all the important data gathered will be jotted down. In the second week, a meeting with the stakeholder and develop a appropriate plan for the planning of the Hospice House. Within one week, an appropriate plan of how the whole project will be implemented is expected to be ready. In the third week, the stakeholders will go to the community to hand flyers and present information about the grand opening. Week 5-6 of the project, the housing facility is expected to have been renovated to fit the setup of a hospice house. Job fairs will be held at that time to hire new staff for the hospice house. Personnel training will be expected to take place at that time also. There might be changes to the implementation project. Therefore, the timeline may vary from date to date. The estimated timeline for the project is eight weeks. Week 7-8, stakeholders will be meeting to go over the implementation plan and make changes to the plan as needed. The management team will be meeting with the vendors such as the pharmacist to go over the implementation plan. All the equipment will be tested to ensure their functionality. Week 9 is the opening of the house. All staff will be there and the community will be invited to the open house. Vitas will be ready to accept patients and transfer all their patients from the contracted facility to the hospice house.
To implement this project, Vitas will need a contracted pharmacist to install a medication Pyxis, to restock the Pyxis, and to help us maintain compliance with the state regulations. The organization will need to hire some vendors to help with the opening of the hospice house. To open a hospice house, the management team needs to create a financial budget for any additional fees and expenses. There will be fees involve with some presentations and handouts. Vitas will need to create a flyer with the description of the hospice house and the services that will be provided. They need to hire an informatics nurse to help with the document system such as bar-code medication administration, nursing documentation, lab results, and other medical forms. Vitas will need an IT Tech to install internet system, telephone access, and the camera system. A manager will be required to coordinate everything with vendors and other personnel. Nurses, certified nursing assistants, and patient care secretaries will be needed for the hospice house. The team will need a meeting room to meet weekly to discuss the plan of care for the patients. Other resources required are educational materials for the new employees and flyers with information about the services that will be provided at the new hospice house.Vitas will need to train all the new hires accordingly to the plan of care of the patients. The new hires will need to be educated on the Pyxis and the computer system. A clinical educator will be required for all the training that Vitas will need to provide to the new employees. All the stakeholders that are going to meet on a regular basis need to be salaried, so no additional allocation for money to staff will be needed.
To come up with the new setup, lots of funds will be required. However, after commencement, the project is expected to be cheap to manage. Therefore, from donations and sponsors, the amount required can be achieved. Also, during the setup, more therapists and nursing staff should be hired as well as technological experts. A good number of nurses should be hired to take part in the home visitation that will be regulated depending on the condition of the patients. To cut on the traveling cost, some company vans have to be purchased for transportation. Computer systems are required for documentation, a camera system is required for safety monitoring, and appropriate staff and environment is required.
For this project, Lewin’s change theory will be a great change theory to use. There are three steps in this theory: unfreezing, moving, and refreezing. In the unfreezing step, the presentation of the hospice house to the leaders occurs. In this step, all the stakeholders will meet to present the importance of a hospice house and the reason why Vitas needs to open one. In the moving step, the implementation of the project occurs. All the staff will be part of the plan. In the refreezing step, the hospice house is established and staff are comfortable and confident when providing end of life care.
Using the Normalization Process Theory (NPT), the project is in a position to intergrade science and technology into the health of the patient. The middle range approach is expected to provide an appropriate platform for the incorporation of the existing social patterns, knowledge as well as health practices (May, 2014). The proposed approach takes the three steps that make sections of the theory. Object – understanding the available resource provided by the management as well as the comfort of the patients. Agents – the projects have identified the individuals that will be expected to implement the whole project. Some of the personnel include nurses and technologists. Context – the environment provided by the management as well as policies and regulation that has been put in place to ensure every section of the project implementation. The iteration depends majorly on the agents and their willingness to act accordingly.
A barrier to the implementation may be getting all the stakeholders together at the same time to discuss the plan. Another barrier is finding a good time and location for a presentation where all the staff can be present because the staff goes to different facilities and they have a different schedule. It might be difficult to find a suitable location with a computer and a screen for the presentation. The implementation of the project may have some delays due to the vendors and personnel involved in the plan of action. To implement a project, the organization and the management team need to keep up with all the vendors and other resources are necessary to help with completing the project. The vendors may not be available when Vitas need them to finish their services. The managers might not be able to hire all the staff that is necessary to open the hospice house. There may be a delay in equipment delivery and set up. Another barrier might be that the new employees do not feel comfortable yet to care for those type of patients, they will require more training. Due to that issue, Vitas might not have enough trained staff to work when the project is implemented.
During the implementation, there are some shortcomings that can be expected. The process may take longer than expected. From the training of the assistant caregivers to the renovation of a fully functional facility, much time will have been consumed. The nurses and other employees may be resistance to the new change. The organization may run out of funds due to other adding that was not part of the plan.Some other complications that can happen to the implementation are the state requirements that the organization may not meet, and the required licenses delayed to open the hospice hospital.
References
Anastasio, M., & Mezo, J. (2015). Integrating home care, hospice &EMS. New York: EMS World. Retrieved from https://www.emsworld.com/article/12047893/mih-partnerships
Halabi, S. (2015). Selling hospice. The Journal of Law, Medicine & Ethics, 42(4), 442-454. Retrieved fromhttps://doi.org/10.1111/jlme.12167
Hudak, M. L., Helm, M. E., & White, P. H. (2017). Principles of childcare healthcare financing.Pediatrics, 140(3). Retrieved fromhttps://doi.org/10.1542/peds.2017-2098
impact of a hospice at home service. Journal of Clinical Nursing, 24(1-2), 131-140. Retrieved fromhttps://doi.org/10.1111/jocn.12695
Jack, B. A., Mitchell, T. K., Cope, L. C., & O’Brien, M. R. (2016). Supporting older people with cancer and life-limited conditions dying at home: A qualitative study of patient and family caregiver experiences of hospice at home care. Journal of Advanced Nursing, 72(9), 2162-2172. Retrieved from https://doi.org/10.1111/jan.12983
Jack, B. A., O’Brien, M. R., Scrutton, J., Baldry, C. R., & Grove, K. E. (2014). Supporting family caregivers providing end-of-life home care: A qualitative study on the
Kruschke, C. (2018). The health care system related to the aging population. Leadership skills for licensed practical nurses working with the aging population, 9-21. Retrieved from: https://link.springer.com/chapter/10.1007/978-3-319-69862-5_2
May, C., Sibley, A., & Hunt, K. (2014). The nursing work of hospital based clinical practice guideline implementation: An explanatory systematic review using normalization process theory. International journal of nursing studies, 51(2), 289-299. Retrieved fromhttps://doi.org/10.1016/j.ijnurstu.2013.06.019
Shalev, A., Phongtankuel, V., Lampa, K., Reid, M. C., Eiss, B. M., Bhatia, S., (2017). Examining the role of primary care physicians and challenges faced when their patients transition to home hospice care. American Journal of Hospice and Palliative Medicine, 35(4), 684-689.Retrieved fromhttps://doi.org/10.1177/1049909117734845
Simpser, E., & Hudak, M. L. (2017). Financing of pediatric home health care. AAP news & journals, 118(2), 834. Retrieved from: https://pediatrics.aappublications.org/content/early/2017/02/23/peds.2016-4202
The health collaborative. (2017. Vitas Healthcare: Bringing end of life conversations to the big screen. Retrieved from https://healthcollab.org/vitas-healthcare-bringing-end-of-life-conversations-to-the-big-screen/
Vitas Healthcare. (2018). Vitas solves the challenges of high-acuity end of life patients. Retrieved from https://www.vitas.com/partners/vitas-solves-the-challenges-of-high-acuity-eol-patients
Wang, S. Y., Aldridge, M. D., Canavan, M., Cherlin, E., & Bradley, E. (2016). Continuous home care reduces hospice disenrollment and hospitalization after hospice enrollment. Journal of pain and symptom management, 52(6), 813-821. Retrieved fromhttps://doi.org/10.1016/j.jpainsymman.2016.05.031
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