Transitions in care during early critical illness

Dr. Lauren Pollack, acting assistant professor (Pulmonary, Critical Care and Sleep Medicine) has received a K23 career development award for her project, “Transitions in care during early critical illness: improving communication and facilitating goal-concordant care for older adults during Emergency Medical Services response.”

Emergency Medical Services (EMS) providers, including Emergency Medical Technicians (EMTs) and paramedics, are often first to respond to sudden health crises among older adults with chronic life-limiting illness.

Innovations in resuscitation science and technology have transformed the delivery of pre-hospital critical care aimed at prolonging patients’ lives. However, some older adults with chronic life-limiting illnesses such as dementia prioritize comfort and quality of life over longevity.

Recent efforts have been made to integrate palliative care and geriatrics principles into critical care medicine, with a predominant focus on hospital and Emergency Department settings. Despite the fact that EMS units provide critical care, and play a crucial role in establishing treatment intensity at illness onset, little is known regarding barriers and facilitators of goal-concordant care for critically ill older adults during 911 EMS response. 

Improving end-of-life care is a national priority, with federal funding recently allocated towards a national palliative care research consortium led by the National Institute on Aging.

This project aims to identify and address barriers to patient-centered care for older adults in the pre-hospital setting through national EMS data analysis, qualitative interviews, and human-centered design of a tool to support improved communication during care transitions.