- Hospice and Palliative Medicine
Clinical Assistant Professor, Medicine - Primary Care and Population Health
Fellowship: Yale New Haven Medical Center (2015) CT
Medical Education: The Flinders University of South Australia (2009) Australia
Residency: Greenwich Hospital Residency Programs (2014) CT
Internship: Greenwich Hospital Residency Programs (2011) CT
Board Certification: American Board of Internal Medicine, Hospice and Palliative Medicine (2016)
Board Certification: American Board of Internal Medicine, Internal Medicine (2014)
Internship: The Flinders University of South Australia (2011) Australia
Graduate and Fellowship Programs
Hospice & Palliative Medicine (Fellowship Program)
Lessons Learned from a Multi-Site, Team-Based Serious Illness Care Program Implementation at an Academic Medical Center.
Journal of palliative medicine
Background: Patients with serious illness benefit from conversations to share prognosis and explore goals and values. To address this, we implemented Ariadne Labs' Serious Illness Care Program (SICP) at Stanford Health Care. Objective: Improve quantity, timing, and quality of serious illness conversations. Methods: Initial implementation followed Ariadne Labs' SICP framework. We later incorporated a team-based approach that included nonphysician care team members. Outcomes included number of patients with documented conversations according to clinician role and practice location. Machine learning algorithms were used in some settings to identify eligible patients. Results: Ambulatory oncology and hospital medicine were our largest implementation sites, engaging 4707 and 642 unique patients in conversations, respectively. Clinicians across eight disciplines engaged in these conversations. Identified barriers that included leadership engagement, complex workflows, and patient identification. Conclusion: Several factors contributed to successful SICP implementation across clinical sites: innovative clinical workflows, machine learning based predictive algorithms, and nonphysician care team member engagement.
View details for DOI 10.1089/jpm.2023.0254
View details for PubMedID 37935036
Education About Specialty Palliative Care Among Non-Healthcare Workers: A Systematic Review.
Journal of pain and symptom management
Despite the expansion of palliative care (PC) services, the public has little knowledge and holds misperceptions about PC, creating barriers to accessing timely specialty PC.To systematically review the evidence regarding the efficacy of educational interventions to improve knowledge and attitudes about PC among non-healthcare workers.We searched five databases (PubMed/MEDLINE, Embase, CIANHL, Web of Science, and Scopus) for studies investigating educational interventions about specialty PC in adults who identified as patients, caregivers, or members of the public. We included studies that were available in English and had a comparator group. We excluded studies that only sampled health professionals or children. We used the Mixed Methods Appraisal Tool to assess quality and risk of bias.Of 12,420 records identified, we screened 5,948 abstracts and assessed 526 full texts for eligibility. 21 articles were extracted for analysis, representing 20 unique educational interventions. Common methodologies included quasi-experimental (9, 45%), randomized controlled trial (4, 20%), and non-randomized trial (2, 10%). Common components of the educational interventions included video presentations (9, 45%), written materials (8, 40%), and lectures (4, 20%). Content included definition (14, 70%) and philosophy (14, 70%) of PC, distinctions between PC and hospice (11, 55%), and eligibility for PC (11, 55%). Fourteen (70%) interventions showed statistically significant positive differences in either knowledge or attitudes about PC.While educational interventions can positively impact knowledge and attitudes about PC among non-healthcare workers, more research is needed to inform the design, delivery, and evaluation of interventions to increase knowledge and attitudes about PC.
View details for DOI 10.1016/j.jpainsymman.2023.09.023
View details for PubMedID 37797678
"The More I Know ... the More I Like It": A Systematic Review Evaluating Public- and Patient-Facing Educational Interventions About Palliative Care
ELSEVIER SCIENCE INC. 2023: E579
View details for Web of Science ID 001006227200128
Just a Sprinkle a Day Takes the Pain Away: Incorporating Topical Opioids for Wound Pain
ELSEVIER SCIENCE INC. 2023: E557-E558
View details for Web of Science ID 001006227200087
What If I Get Seriously Ill? A Virtual Workshop for Advance Care Planning During COVID-19.
Journal of pain and symptom management
The coronavirus disease 2019 (COVID-19) has brought public attention to questions regarding the type of care individuals would want to receive in the event of becoming suddenly critically ill. Advance care planning (ACP) is one way to help individuals and families address these questions. However, social distancing, stay-at-home orders, and hospital visitor restrictions have raised new barriers to facilitating these conversations. Here, we describe the implementation and evaluation of a novel, public-facing, 2-part virtual ACP workshop. Participants were recruited through electronic communication, and evaluations were collected through surveys administered after each part of the workshop. We found that utilizing a virtual format allowed us to reach a large, geographically diverse audience. Participants were likely to recommend the workshop to friends and family. There was no change in advance care planning engagement between the post-session surveys between the first and second parts of the workshop.
View details for DOI 10.1016/j.jpainsymman.2020.08.022
View details for PubMedID 32835831
"Don't Limit Me'': Discussing Serious News with Intellectually Disabled Adults
ELSEVIER SCIENCE INC. 2018: 622
View details for Web of Science ID 000425399300190
- Air Travel at the End of Life #338 JOURNAL OF PALLIATIVE MEDICINE 2017; 20 (10): 1160–61
- The Birds and Bees Do It, So Why Can't We Talk About It? Intimacy and Sexuality in Serious Illness and at the End of Life ELSEVIER SCIENCE INC. 2017: 343