Vol. 47 No. 2 February 2014 387Schedule With Abstracts

methodology, results, and lessons learned fromthis 2-year initiative.

Palliative Care in the Era of HypothermiaProtocols (TH302)Robert Smeltz, MA RN NP ACHPN, NYU Schoolof Medicine/Bellevue Hospital, New York, NY.Lisa Zelnick, MD, Bellevue Hospital Center,New York, NY. Susan Cohen, MD, Bellevue Hos-pital Center, New York, NY. Rebecca Freeman,LMSW, Bellevue Hospital Center, New York, NY.(All authors listed above had no relevant finan-cial relationships to disclose.)

Objectives1. Review the pathophysiology of anoxic brain

injury following cardiac arrest with sponta-neous recovery of circulation.

2. Describe the nuts and bolts of hypothermicprotocols and the impact it has had onprognosis.

3. Demonstrate best practices for communi-cating prognosis with families in the settingof anoxic brain injury.

Palliative care is an important part of care for pa-tients who suffer an anoxic brain injury post car-diac arrest. Prior to the advent of hypothermiaprotocols, very few patients with anoxic braininjury had a good outcome if they did not regainconsciousness in the first 72 hours, or if they hadother poor prognostic indicators, such as no mo-tor response or pupillary response (Wiggins etal., Neurology, 2006). Now, it has been demon-strated in some situations that 8% to 24% of pa-tients have a favorable outcome, and someprognostic indicators are not as reliable (DeGeorgia et al., Neurology, 2012).

This presents a challenge to palliative care inthe counseling and establishing goals of carewhen the prognosis is less certain. Palliativecare can help families understand the compli-cated medical information and support careplanning in the shifting sands of prognosis.

This concurrent session will discuss the care ofpatients who suffered an anoxic brain injury andcommunication strategies for when the patient’sprognosis is less certain. We will present infor-mation on hypothermia protocols and howthese protocols have changed prognosticationand the role of palliative care in cardiac arrestwith anoxic injury. We will describe case exam-ples, communication challenges, and strategiesin the clinical setting. We will share experiencesand relevant data from a Bellevue Hospital

Center quality improvement project, whichaims to facilitate earlier involvement of palliativecare in anoxic brain injury.

AAHPM Measuring What Matters Project:Why It Matters What You Measure (TH303)Dale Lupu, PhD MPH, American Academy ofHospice and Palliative Medicine, Chicago, IL.David Casarett, MD MA, University of Pennsylva-nia, Philadelphia, PA. Suzana Makowski, MDMMM FACP FAAHPM, UMass Memorial Medi-cal Center and UMass Medical School,Worcester, MA. Katherine Ast, MSW LCSW,American Academy of Hospice and PalliativeMedicine, Chicago, IL.(All authors listed above had no relevant finan-cial relationships to disclose with the followingexceptions: Lupu is a consultant for and receivesconsulting fees from Daleview Associates, andMakowski is an advisor for and receives 0.1 percent of H-STAR company profits if and whensold.)

Objectives1. Describe the rationale and methods for the

development of the AAHPM ‘‘MeasuringWhat Matters’’ panel of palliative care qual-ity measures.

2. Identify the benefits of implementing the‘‘Measuring What Matters’’ quality mea-sures in your own program.

3. Describe resources for assisting programsin incorporating ‘‘Measuring What Mat-ters’’ into their quality improvement pro-grams and in aligning with other nationalquality initiatives.

Leaders of AAHPM’s ‘‘Measuring What Matters’’Task Force will address how palliative care pro-viders can

� Integrate ‘‘Measuring What Matters’’ intotheir quality improvement programs.

� Use ‘‘Measuring What Matters’’ results topromote palliative care as part of systeminnovation.

Because few national quality programs fit easilywith palliative care concerns and goals, palliativecare practitioners have been challenged to findapplicable quality measures that can be bench-markednationally. TheAAHPMQuality andPrac-tice Standards Task Force undertook a consensusproject in 2013 to create a recommendedpanel ofmeasures for all non-hospice palliative care pro-grams. The resulting panel of measures, called‘‘Measuring What Matters’’ will serve as the

388 Vol. 47 No. 2 February 2014Schedule With Abstracts

foundation for further development of palliativecare quality projects nationally. This workshopwill explain how the panel of measures was devel-oped and help participants understand how tointegrate the measures into their own qualityimprovement efforts. Next steps for implement-ing ‘‘Measuring What Matters’’ shared projectswill also be explained.

Pediatric Oncology 911: What PalliativeCare and Hospice Providers Should KnowAbout Caring for Children with ProgressiveCancer (TH304)Jennifer Hwang, MD MHS, The Children’s Hos-pital of Philadelphia, Philadelphia, PA. TammyKang, MD, The Children’s Hospital of Philadel-phia, Philadelphia, PA. Rosanna Pollack, MSNRN PNP-BC, The Children’s Hospital of Phila-delphia, Philadelphia, PA.(All authors listed above had no relevant finan-cial relationships to disclose.)

Objectives1. Describe five common oncologic emergen-

cies in pediatric patients who may bereceiving home hospice services.

2. Describe three challenges created by inte-grating palliative care and curativetherapies.

3. Describe evidence-based management stra-tegies for five oncologic emergencies,including the use of surgery, chemotherapy,and radiation therapy.

Childhood cancer remains the leading cause ofdeath by disease for children and adolescentsin the United States. Survival rates are widely var-iable. Although there have been improvementsin the cure rates of some tumors, other tumorshave long-term survival rates less than 20%. Palli-ative care is an essential part of caring for chil-dren with advanced cancer. The PatientProtection and Affordable Care Act signed intolaw in 2010 by President Obama contained aprovision to provide simultaneous access toboth curative therapy and hospice services forchildren insured through Medicaid and CHIP.This provision, termed the Concurrent Carefor Children Requirement, has resulted inmore children receiving aggressive diseasedirected therapies while simultaneously beingcared for by hospice providers. It is important,therefore, for hospice providers to becomemore familiar with oncologic emergencies thatmay occur in patients undergoing cancer

therapy because parent and patient goals mightbe to aggressively treat these emergencies andsome emergencies may be reversible. Using acase based discussion, we intend to discuss man-agement strategies for common oncologicemergencies, including increased intracranialpressure, superior vena cava syndrome, sepsis,spinal cord compression, and hyperleukocytosis.Available medical literature for treatment op-tions will also be reviewed.

Hear Today, Gone Tomorrow: WorkingEffectively With Seriously Ill Patients withLimited Health Literacy and Numeracy(TH305)Vyjeyanthi Periyakoil, MD, Stanford UniversitySchool of Medicine, Palo Alto, CA.(Periyakoil had no relevant financial relation-ships to disclose.)

Objectives1. Gain an initial understanding of health lit-

eracy and numeracy and how they impactcommunication and decision making aboutserious illness with multi-cultural patientsand families.

2. Identify the four levels of health literacyand two tools to evaluate health literacyand numeracy at the bedside.

3. Identify at least two specific ways to inte-grate health literacy into your work toimprove the care of diverse patients withserious illness and their families.

Health literacy is the degree to which individualshave the capacity to obtain, understand, andretain basic health information and servicesneeded to make appropriate health decisions.Health numeracy is the ability to understandand use quantitative information about health.Approximately 80 million Americans are esti-

mated to have limited health literacy, numeracy,or both. One in three American adults has diffi-culty with common health tasks, such asfollowing directions on a prescription drug la-bel. The number of those who have difficultycomprehending the intricacies of serious illnessand the decision making it requires is likelymuch higher.Additionally, there is a disproportionately

high prevalence of limited health literacy andnumeracy in older adults, racial and ethnic mi-norities, and those with low socioeconomic sta-tus. Data show that persons with limited healthliteracy skills are more likely to utilize emergency