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Creating a Dedicated Palliative Care Team for ICU Spanish Speaking Patients in Response to COVID-19
Carine Davila1, Leslie Cartagena2, Sarah Byrne-Martelli2
1Division of Palliative Care and Geriatrics (C.D., L.C., S.B.M., M.S.), Massachusetts General Hospital, Boston, Massachusetts, USA; Harvard Medical School (C.D., M.S.), Boston, Massachusetts, USA.
Context:
The Latinx population faced higher rates of infection and severe illness during the COVID-19 pandemic, resulting in an increased need for palliative care services.
Objectives:
We describe the creation and impact of a formal palliative care initiative developed for seriously ill, Spanish-speaking patients during the COVID-19 pandemic at a tertiary care academic medical center.
Methods:
Patients were enrolled in the Spanish Palliative Care Initiative during a two-month period starting in April 2020. Selected patients were longitudinally followed by a rotating team of Spanish-speaking palliative care clinicians. Following the intervention, a retrospective chart review was conducted to evaluate the impact of the program.
Results:
We enrolled 22 patients. The most frequent palliative care task completed during the initial visit was information giving (77%) and during follow-up visits were goals of care discussion (59%) and coping support (59%). Fifteen patients (68%) had a change in code status and 4 patients (18%) were discharged to hospice.
Conclusion:
The creation of a focused clinical program targeting a historically marginalized population offered opportunity for early palliative care intervention in clinical care for Spanish-speaking patients. This underscores the need for Spanish-language concordant palliative care to improve serious illness care, and end-of-life care, by providing continuity of care, spiritual care, and ICU team support.
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