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2. Characterizing usual-care physical rehabilitation in Canadian intensive care unit patients: a secondary analysis of the Canadian multicentre Critical Care Cycling to Improve Lower Extremity Strength pilot randomized controlled trial

Author

O’Grady, Heather K., Ball, Ian, Berney, Sue, Burns, Karen E. A., Cook, Deborah J., Fox-Robichaud, Alison, Herridge, Margaret S., Karachi, Timothy, Mathur, Sunita, Reid, Julie C., Rochwerg, Bram, Rollinson, Thomas, Rudkowski, Jill C., Bosch, Jackie, Turkstra, Lyn S., and Kho, Michelle E.

Published
2024
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3. A Canadian survey of perceptions and practices related to ordering of blood tests in the intensive care unit

Author

Rahman, M. Omair, Charbonney, Emannuel, Vaisler, Ryan, Khalifa, Abubaker, Alhazzani, Waleed, Gossack-Keenan, Kiera, Garland, Allan, Karachi, Timothy, Duan, Erick, Bagshaw, Sean M., Meade, Maureen O., Hillis, Chris, Kavsak, Peter, Born, Karen, Mbuagbaw, Lawrence, Siegal, Deborah, Millen, Tina, Scales, Damon, Amaral, Andre, English, Shane, McCredie, Victoria A., Dodek, Peter, Cook, Deborah J., and Rochwerg, Bram

Published
2024
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5. The response of Canada's clinical health research ecosystem to the COVID-19 pandemic

Author

Lamontagne, Francois, Masse, Marie-Helene, Yarnell, Christopher, Camirand-Lemyre, Felix, Levesque, Simon, Domingue, Marie-Pier, O'Hearn, Katie, Watpool, Irene, Hoogenes, Jennifer, Sprague, Sheila, Menard, Julie, Lemaire-Paquette, Samuel, Hebert-Dufresne, Laurent, Cook, Deborah, Hebert, Paul, Rowan, Kathryn, Yada, Nicole, Menon, Kusum, Fowler, Robert, Fox-Robichaud, Alison, Boutin, Denis, Marshall, John, and Kho, Michelle E.

Subjects
Canada -- Health aspects, Epidemics -- Research -- Canada, Medical research -- Methods, Medicine, Experimental -- Methods, Health
Abstract

Background: The response of Canada's research community to the COVID-19 pandemic provides a unique opportunity to examine the country's clinical health research ecosystem. We sought to describe patterns of enrolment across Canadian Institutes of Health Research (CIHR)-funded studies on COVID-19. Methods: We identified COVID-19 studies funded by the CIHR and that enrolled participants from Canadian acute care hospitals between January 2020 and April 2023. We collected information on study- and site-level variables from study leads, site investigators, and public domain sources. We described and evaluated factors associated with cumulative enrolment. Results: We obtained information for 23 out of 26 (88%) eligible CIHR-funded studies (16 randomized controlled trials [RCTs] and 7 cohort studies). The 23 studies were managed by 12 Canadian and 3 international coordinating centres. Of 419 Canadian hospitals, 97 (23%) enrolled a total of 28 973 participants--3876 in RCTs across 78 hospitals (median cumulative enrolment per hospital 30, interquartile range [IQR] 10-61), and 25 097 in cohort studies across 62 hospitals (median cumulative enrolment per hospital 158, IQR 6-348). Of 78 hospitals recruiting participants in RCTs, 13 (17%) enrolled 50% of all RCT participants, whereas 6 of 62 hospitals (9.7%) recruited 54% of participants in cohort studies. Interpretation: A minority of Canadian hospitals enrolled the majority of participants in CIHR-funded studies on COVID-19. This analysis sheds light on the Canadian health research ecosystem and provides information for multiple key partners to consider ways to realize the full research potential of Canada's health systems., Providing 'best care at lower cost' is the goal of a learning health system. (1) Accomplishing this goal hinges on an efficient health research ecosystem, and a cohesive national research [...]

Published
2024
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6. Protocol implementation during the COVID-19 pandemic: experiences from a randomized trial of stress ulcer prophylaxis

Author

Dennis, Brittany, Deane, Adam, Lauzier, François, Zytaruk, Nicole, Hardie, Miranda, Hammond, Naomi, Finfer, Simon, Arabi, Yaseen, Marshall, John, Saunders, Lois, Heels-Ansdell, Diane, Myburgh, John, Knowles, Serena, Muscedere, John, Ostermann, Marlies, Rajbhandari, Dorrilyn, English, Shane, Matic, Karlo, Venkatesh, Bala, Al Fares, Abdulrahman, Guyatt, Gordon, Alhazzani, Waleed, Mumtaz, Hassan, Poole, Alexis, Xie, Feng, Thabane, Lehana, Hall, Richard, and Cook, Deborah

Published
2024
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11. Enhancing end of life care on general internal medical wards: the 3 Wishes Project

Author

Reid, Julie C, Dennis, Brittany, Hoad, Neala, Clarke, France, Hanmiah, Rajendar, Vegas, Daniel Brandt, Boyle, Anne, Toledo, Feli, Rudkowski, Jill C, Soth, Mark, Heels-Ansdell, Diane, Cheung, Andrew, Willison, Kathleen, Neville, Thanh H, Cheung, Jason, Woods, Anne, and Cook, Deborah

Subjects
Health Services and Systems, Health Sciences, Prevention, Good Health and Well Being, Humans, Pandemics, COVID-19, Terminal Care, Hospice Care, Intensive Care Units, End-of-life, Palliative care, Acute care, Compassionate care, Patient-centered care, Empathy, Nursing, Public Health and Health Services, Gerontology, Health services and systems
Abstract

BackgroundInitially developed in the intensive care unit (ICU) at St. Joseph's Healthcare Hamilton (SJHH) the 3 Wishes Project (3WP) provides personalized, compassionate care to dying patients and their families. The objective of this study was to develop and evaluate 3WP expansion strategies for patients cared for on General Internal Medicine (GIM) wards in our hospital.MethodsFrom January 2020-November 2021, we developed a phased, multicomponent approach for program expansion. We enrolled patients on the GIM wards who had a high probability of dying in hospital, then elicited, implemented, and documented wishes for them or their families. Data were analyzed descriptively.ResultsFrom March 2020 to November 2020, we implemented staff education and engagement activities, created an Expansion Coordinator position, held strategic consultations, and offered enabling resources. From March 2020 to November 2021, we enrolled 62 patients and elicited 281 wishes (median [1st, 3rd quartiles] 4 [4, 5] wishes/patient). The most common wish categories were personalizing the environment (67 wishes, 24%), rituals and spiritual support (42 wishes, 15%), and facilitating connections (39 wishes, 14%). The median [1st, 3rd] cost/patient was $0 [0, $10.00] (range $0 to $86); 91% of wishes incurred no cost to the program.ConclusionsThe formal expansion of the 3WP on GIM wards has been successful despite COVID-19 pandemic disruptions. While there is still work ahead, these data suggest that implementing the 3WP on the GIM wards is feasible and affordable. Increased engagement of the clinical team during the pandemic suggests that it is positively received.

Published
2023

12. The 3 Wishes Program Improves Families’ Experience of Emotional and Spiritual Support at the End of Life

Author

Neville, Thanh H, Taich, Zachary, Walling, Anne M, Bear, Danielle, Cook, Deborah J, Tseng, Chi-Hong, and Wenger, Neil S

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Humans, Terminal Care, Hospice Care, Spirituality, Emotions, Death, Family, End of life, Palliative care, Intensive care unit, Clinical Sciences, General & Internal Medicine, Clinical sciences, Health services and systems, Public health
Abstract

BackgroundThe end-of-life (EOL) experience in the intensive care unit (ICU) is emotionally challenging, and there are opportunities for improvement. The 3 Wishes Program (3WP) promotes the dignity of dying patients and their families by eliciting and implementing wishes at the EOL.AimTo assess whether the 3WP is associated with improved ratings of EOL care.Program descriptionIn the 3WP, clinicians elicit and fulfill simple wishes for dying patients and their families.Setting2-hospital academic healthcare system.ParticipantsDying patients in the ICU and their families.Program evaluationA modified Bereaved Family Survey (BFS), a validated tool for measuring EOL care quality, was completed by families of ICU decedents approximately 3 months after death. We compared patients whose care involved the 3WP to those who did not using three BFS-derived measures: Respectful Care and Communication (5 questions), Emotional and Spiritual Support (3 questions), and the BFS-Performance Measure (BFS-PM, a single-item global measure of care).ResultsOf 314 completed surveys, 117 were for patients whose care included the 3WP. Bereaved families of 3WP patients rated the Emotional and Spiritual Support factor significantly higher (7.5 vs. 6.0, p = 0.003, adjusted p = 0.001) than those who did not receive the 3WP. The Respectful Care and Communication factor and BFS-PM were no different between groups.DiscussionThe 3WP is a low-cost intervention that may be a feasible strategy for improving the EOL experience.

Published
2023

14. Differences in directives to limit treatment and discontinue mechanical ventilation between elderly and very elderly patients: a substudy of a multinational observational study

Author

Burns, Karen E. A., Cook, Deborah J., Xu, Keying, Dodek, Peter, Villar, Jesús, Jones, Andrew, and Kapadia, Farhad N.

Subjects
Aged patients -- Health aspects, Mortality -- Ontario -- United Kingdom -- India -- Australia -- Canada -- Spain, Hospital patients -- Health aspects, Tracheostomy -- Health aspects, Health care industry
Abstract

Purpose The aim of this study was to characterize differences in directives to limit treatments and discontinue invasive mechanical ventilation (IMV) in elderly (65-80 years) and very elderly (> 80 years) intensive care unit (ICU) patients. Methods We prospectively described new written orders to limit treatments, IMV discontinuation strategies [direct extubation, direct tracheostomy, spontaneous breathing trial (SBT), noninvasive ventilation (NIV) use], and associations between initial failed SBT and outcomes in 142 ICUs from 6 regions (Canada, India, United Kingdom, Europe, Australia/New Zealand, United States). Results We evaluated 788 (586 elderly; 202 very elderly) patients. Very elderly (vs. elderly) patients had similar withdrawal orders but significantly more withholding orders, especially cardiopulmonary resuscitation and dialysis, after ICU admission [67 (33.2%) vs. 128 (21.9%); p = 0.002]. Orders to withhold reintubation were written sooner in very elderly (vs. elderly) patients [4 (2-8) vs. 7 (4-13) days, p = 0.02]. Very elderly and elderly patients had similar rates of direct extubation [39 (19.3%) vs. 113 (19.3%)], direct tracheostomy [10 (5%) vs. 40 (6.8%)], initial SBT [105 (52%) vs. 302 (51.5%)] and initial successful SBT [84 (80%) vs. 245 (81.1%)]. Very elderly patients experienced similar ICU outcomes (mortality, length of stay, duration of ventilation) but higher hospital mortality [26 (12.9%) vs. 38 (6.5%)]. Direct tracheostomy and initial failed SBT were associated with worse outcomes. Regional differences existed in withholding orders at ICU admission and in withholding and withdrawal orders after ICU admission. Conclusions Very elderly (vs. elderly) patients had more orders to withhold treatments after ICU admission and higher hospital mortality, but similar ICU outcomes and IMV discontinuation. Significant regional differences existed in withholding and withdrawal practices., Author(s): Karen E. A. Burns [sup.1] [sup.2] [sup.3] [sup.4], Deborah J. Cook [sup.4] [sup.5], Keying Xu [sup.3] [sup.6], Peter Dodek [sup.7] [sup.8], Jesús Villar [sup.9] [sup.10], Andrew Jones [sup.11], Farhad [...]

Published
2023
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16. Patient-important upper gastrointestinal bleeding in the ICU: A mixed-methods study of patient and family perspectives

Author

Vanstone, Meredith G., Krewulak, Karla, Taneja, Shipra, Swinton, Marilyn, Fiest, Kirsten, Burns, Karen E.A., Debigare, Sylvie, Dionne, Joanna C., Guyatt, Gordon, Marshall, John C., Muscedere, John G., Deane, Adam M., Finfer, Simon, Myburgh, John A., Gouskos, Audrey, Rochwerg, Bram, Ball, Ian, Mele, Tina, Niven, Daniel J., English, Shane W., Verhovsek, Madeleine, and Cook, Deborah J.

Published
2024
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18. REVISE: re-evaluating the inhibition of stress erosions in the ICU—statistical analysis plan for a randomized trial

Author

Heels-Ansdell, Diane, Billot, Laurent, Thabane, Lehana, Alhazzani, Waleed, Deane, Adam, Guyatt, Gordon, Finfer, Simon, Lauzier, François, Myburgh, John, Young, Paul, Arabi, Yaseen, Marshall, John, English, Shane, Muscedere, John, Ostermann, Marlies, Venkatesh, Bala, Zytaruk, Nicole, Hardie, Miranda, Hammond, Naomi, Knowles, Serena, Saunders, Lois, Poole, Alexis, Al-Fares, Abdulrahman, Xie, Feng, Hall, Richard, and Cook, Deborah

Published
2023
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19. Frequency of screening and SBT Technique Trial—North American Weaning Collaboration (FAST-NAWC): an update to the protocol and statistical analysis plan

Author

Burns, Karen E. A., Lafrienier-Roula, Myriam, Hill, Nicholas S., Cook, Deborah J., Seely, Andrew J. E., Rochwerg, Bram, Mayette, Michael, D’Aragon, Frederick, Devlin, John W., Dodek, Peter, Tanios, Maged, Gouskos, Audrey, Turgeon, Alexis F., Aslanian, Pierre, Sia, Ying Tung, Beitler, Jeremy R., Hyzy, Robert, Criner, Gerard J., Kassis, Elias Baedorf, Tsang, Jennifer L. Y., Meade, Maureen O., Liebler, Janice M., Wong, Jessica T. Y., and Thorpe, Kevin E.

Published
2023
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20. Proton pump inhibitors in critically ill mechanically ventilated patients with COVID-19: protocol for a substudy of the Re-EValuating the Inhibition of Stress Erosions (REVISE) Trial

Author

Dennis, Brittany B., Thabane, Lehana, Heels-Ansdell, Diane, Dionne, Joanna C., Binnie, Alexandra, Tsang, Jennifer, Guyatt, Gordon, Ahmed, Aijaz, Lauzier, François, Deane, Adam, Arabi, Yaseen, Marshall, John, Zytaruk, Nicole, Saunders, Lois, Finfer, Simon, Myburgh, John, Muscedere, John, English, Shane, Ostermann, Marlies, Hardie, Miranda, Knowles, Serena, and Cook, Deborah

Published
2023
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23. Sacrifice and solidarity: a qualitative study of family experiences of death and bereavement in critical care settings during the pandemic

Author

Dennis, Brittany, Vanstone, Meredith, Swinton, Marilyn, Vegas, Daniel Brandt, Dionne, Joanna C, Cheung, Andrew, Clarke, France J, Hoad, Neala, Boyle, Anne, Huynh, Jessica, Toledo, Feli, Soth, Mark, Neville, Thanh H, Fiest, Kirsten, and Cook, Deborah J

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Good Health and Well Being, Bereavement, COVID-19, Canada, Critical Care, Family, Grief, Humans, Pandemics, Qualitative Research, SARS-CoV-2, palliative care, qualitative research, Clinical Sciences, Public Health and Health Services, Other Medical and Health Sciences, Biomedical and clinical sciences, Health sciences, Psychology
Abstract

BackgroundPandemic-related restrictions are expected to continue to shape end-of-life care and impact the experiences of dying hospitalised patients and their families.ObjectiveTo understand families' experiences of loss and bereavement during and after the death of their loved one amidst the SARS-CoV-2 (COVID-19) pandemic.DesignQualitative descriptive study.SettingThree acute care units in a Canadian tertiary care hospital.ParticipantsFamily members of 28 hospitalised patients who died from March-July 2020.Main outcome measuresQualitative semistructured interviews conducted 6-16 months after patient death inquired about family experiences before and beyond the death of their loved one and garnered suggestions to improve end-of-life care.ResultsPandemic restrictions had consequences for families of dying hospitalised patients. Most family members described an attitude of acquiescence, some framing their experience as a sacrifice made for the public good. Families appreciated how clinicians engendered trust in the name of social solidarity while trying to mitigate the negative impact of family separation. However, fears about the patient's experience of isolation and changes to postmortem rituals also created despair and contributed to long-lasting grief.ConclusionProfound loss and enduring grief were described by family members whose final connections to their loved one were constrained by pandemic circumstances. Families observed solidarity among clinical staff and experienced a sense of unity with staff, which alleviated some distress. Their suggestions to improve end-of-life care given pandemic restrictions included frequent, flexible communication, exceptions for family presence when safe, and targeted efforts to connect patients whose isolation is intensified by functional impairment or limited technological access.Trial registration numberNCT04602520; Results.

Published
2022

24. The authors reply

Author

Angriman, Federico, Muttalib, Fiona, Lamontagne, François, Adhikari, Neill K. J., Chassé, Michaël, Aslanian, Pierre, Bélisle, Sylvain, Cailhier, Jean-François, Martin Carrier, François, Charbonney, Emmanuel, Denault, André, Girard, Martin, Guimond, Jean-Gilles, Halwagi, Antoine, Hébert, Paul, Kolan, Christophe, Ouellet, Caroline, Robillard, Nicholas, Benettaib, Fatna, Boumahni, Dounia, Lebrasseur, Martine, Salamé, Maya, Cantin, Marie-Ève, Archambault, Patrick, Drouin, Christine, Duquet-Deblois, Estel, Noël-Hunter, Monia, Dubé, Jean-Nicolas, Bériault, Marie-Josée, Chacon, Marco, Claveau, David, Naud, Jean-François, Rodrigue, Élise, Tapss, Danielle, Toupin, Guylaine, Ting Wang, Han, Brosseau, Marc, Laufer, Brian, Marquis, François, Toupin, Francis, Tassy, Danaë, Cheung, Vincent, Toun, Sam-Ang, Lamontagne, François, D’Aragon, Frédérick, Bérard, Dominique, Grondin-Beaudoin, Brian, Leclair, Marc-André, Lesur, Olivier, Mayette, Michaël, Poulin, Yannick, Quiroz Martinez, Hector, St-Arnaud, Charles, Carbonneau, Elaine, Bélisle, Julie, Bouchard, Marie-Pier, Côté, Line, Ladouceur, Marylène, Marchand, Joannie, Naisby, Alexandra, Robert-Petit, Louise, Thibault, Marie-Ève, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Williams, Virginie, Lainer Palacios, Julia, Lauzier, François, Francoeur, Charles, Leblanc, Guillaume, St-Onge, Maude, Turgeon, Alexis, Bellemare, David, Boulanger, Marie-Claude, Cloutier, Eve, Guilbault, Gabrielle, Thibeault, Frédérique, Belley-Côté, Emilie, Fox-Robichaud, Alison, Meade, Maureen, Whitlock, Richard, Hand, Lori, Hayward, Leah, Mullen, Courtney, Savija, Nevena, Lellouche, François, Simon, Mathieu, Tung Sia, Ying, Lizotte, Patricia, Rochwerg, Bram, Millen, Tina, Maslove, David, Gordon Boyd, J., Drover, John, Muscedere, John, Sibley, Stephanie, Boyd, Tracy, Hunt, Miranda, Mele, Tina, Bentall, Tracey, ElKhatib, Chadia, Shahin, Jason, Khwaja, Kosar, Campisi, Josie, Alam, Norine, Rahgoshai, Raham, Mehta, Sangeeta, Detsky, Michael, Shah, Sumesh, Kohli, Sonny, Cui, Fulan, Khera, Vikas, McConachie, David, Rehsia, Sachdeep, Bharti, Dalisha, Perez, Adic, James Kutsogiannis, Demetrios, Chowdhury, Raiyan, Davidow, Jon, Johnston, Curtis, Kim, Michael, Macala, Kimberley, Marcushamer, Sam, Markland, Darren, Matheson, Doug, Parker, Arabesque, Paton-Gay, Damian, Hewer, Tayne, Thompson, Patrica, Cook, Deborah, Al-Hazzani, Waleed, Duan, Erick, Ligori, Tania, Soth, Mark, Clarke, France, Copland, Mary, Matic, Karlo, Adhikari, Neill KJ, Amaral, Andre, Cuthbertson, Brian H, Fowler, Robert A, Piquette, Dominique, Scales, Damon C, Tillmann, Bourke, Wunsch, Hannah, Marinoff, Nicole, Kamra, Maneesha, Kaur, Navjot, Murali, Deeptha, Sabananthan, Thivya, Sugumaran, Thuva, Seely, Andrew, English, Shane, Meggison, Hilary, Microys, Sherissa, Millington, Scott, Sarti, Aimee, Haines, Jessica, Miezitis, Sydney, Porteous, Rebecca, Watpool, Irene, Del Sorbo, Lorenzo, Fan, Eddy, Granton, John, Abdelhady, Hesham, Romagnuolo, Tina, Rewa, Oleksa, Bagshaw, Sean, Meier, Michael, Sligl, Wendy, Baig, Nadia, Wood, Gordon, Ovakim, Daniel, Auld, Fiona, Carney, Gayle, Parfett, Deborah, Leblanc, Rémi, Poirier, Matthieu, Theriault, Theophile, Williston, Maryse, Caissie Collette, Jackie, Carriere, Melanie, Daigle, Melissa, Gaudet, Bernise, Morin, Karine, Ouellette-Bernier, Lola, Poitras, Julie, Robichaud, Melanie, Rockburn, Joanne, Mekontso Dessap, Armand, Arrestier, Romain, Bagate, François, Bendib, Ines, Benelli, Brice, Berti, Enora, Bertier, Astrid, Cavaleiro, Pedro, de Prost, Nicolas, Gendreau, Segolene, Hartman, Otto, Haudebourg, Anne-Fleur, Lopinto, Julien, Masi, Paul, Michaud, Gaël, Razazi, Keyvan, Tuffet, Samuel, Alves, Aline, Nait Chabane, Luiza, Ouali, Fariza, Ouedraogo, Rachida, Annane, Djillali, Abdeladim, Lilia, Bounab, Rania, Heming, Nicholas, Maxime, Virginie, Moine, Pierre, Bossard, Isabelle, Jourdier, Segolene, Mahiou, Siline, Tessa, Hayette, McGuinness, Shay, Ball, Jonathan, Hennessy, Immanuel, Hogan, Maurice, Butler, Magdalena, Cowdrey, Keri-Anne, Gilder, Eileen, Parke, Rachael, Ryan, Samantha, Woollett, Melissa, Van Der Poll, Andrew, Benson-Cooper, Kerry, Chen, Jonathan, Freeman, Kirk, Harley, David, Harvey, Dave, Hourigan, Craig, Julian, Kylie, Lo, Stephen, McArthur, Colin, Miller, Stuart, Pointer, Chris, Anthony Smith, Rex, Tincknell, Laura, McConnochie, Rachael, Simmonds, Catherine, Shaw, Geoffrey, Betteridge, Toby, Burke, Brandon, Closey, David, Crombie, Rosalind, Davidson, Neil, Henderson, Louise, Henderson, Seton, Hitchings, Louise, Knight, David, Quigley, Christine, Ritzema Carter, Jay, Roberts, Jessica, Townend, Katherine, Doyle, Tara, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Van Der Heyden, Kymbalee, Twardowski, Pawel, Dvoracek, Martin, Renner, Markus, Silverman, David, Smith, Myles, Monica Stephens, Katherine, Albert Waibel, Hansjörg, Wiebe, Stefan, Woolley, Mark, Eden, Amie, France, Dawn, Buehner, Ulrike, Erin Williams, Katallah Kramer, Browne, Troy, Callender, Owen, Chen, Jonathan, Farrell, Susanne, Higson, Vicky, Jackson, David, Keet, Owen, Goodson, Jennifer, Martynoga, Robert, Byrne, Kelly, Butler, Amelia, Trask, Kara, Mans, Gay, Termaat, Jonathan, Young, Paul, Barnes, Colin, Barry, Ben, Grayson, Kim, Moore, James, Psirides, Alex, Sturland, Shawn, Tietjens, Kate, Ure, Bob, Walker, Laurence, Wright, Jason, Aguilar-Dano, April, Delaney, Kirsha, Lawrence, Cassie, Lesona, Mildred, Millington, Alexandra, Navarra, Leanlove, Olatunji, Shaanti, Sol Cruz, Raulle, Sol Cruz, Rhoze, Young, Chelsea, Day, Andrew, Cook, Deborah J, Guyatt, Gordon H, Sprague, Sheila, Cohen, Dian, Heyland, Daren K, Lamontagne, François, Masse, Marie-Hélène, Ménard, Julie, Adhikari, Neill KJ, Pinto, Ruxandra, Kanji, Salmaan, Battista, Marie-Claude, Annane, Djillali, Tirupakuzhi Vijayaraghavan, Bharath Kumar, McGuinness, Shay, Parke, Rachael, and Arabi, Yaseen

Published
2023
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26. End-of-Life Care During the Coronavirus Disease 2019 Pandemic: The 3 Wishes Program

Author

Neville, Thanh H, Bear, Danielle K, Kao, Yuhan, Xu, Xueqing Sherry, Hjelmhaug, Kristen, Quebral, Desiree, Sanaee, Natalie, Hainje, Jessica, Arriola, Genevieve, Granone, Maria Carmela, White, Elizabeth, Chaturvedi, Apurva, Yu, Shuyi, Clarke, France, and Cook, Deborah J

Subjects
Clinical Research, Prevention, Clinical Trials and Supportive Activities, Management of diseases and conditions, 7.2 End of life care, Good Health and Well Being, coronavirus disease 2019, end-of-life, intensive care unit, palliative care, pandemic, patient-centered care
Abstract

Patient- and family-centered end-of-life care can be difficult to achieve in light of visitation restrictions and infection-prevention measures. We evaluated how the 3 Wishes Program evolved to allow continued provision of compassionate end-of-life care for critically ill patients during the coronavirus disease 2019 pandemic.DesignThis is a prospective observational study where data were collected 1 year prior to the coronavirus disease 2019 pandemic and 1 year after (from March 1, 2019, to March 31, 2021). The number of deceased patients whose care involved the 3 Wishes Program, their characteristics, and wishes were compared between prepandemic and pandemic periods.SettingSix adult ICUs of a two-hospital health system in Los Angeles.PatientsDeceased patients whose care involved the 3 Wishes Program.InterventionsThe 3 Wishes Program is a palliative care intervention in which individualized wishes are implemented for dying patients and their families.Measurements and main resultsDuring the study period, the end-of-life care for 523 patients involved the 3 Wishes Program; more patients received the 3 Wishes Program as part of their end-of-life care during the pandemic period than during the prepandemic study period (24.8 vs 17.6 patients/mo; p = 0.044). Patients who died during the pandemic compared with prepandemic were less likely to have family at the bedside and more likely to have postmortem wishes fulfilled for their families. Compared with the 736 wishes implemented during the prepandemic period, the 969 wishes completed during the pandemic were more likely to involve keepsakes. Wishes were most commonly implemented by bedside nurses, although the 3 Wishes Program project manager (not involved in the patient's clinical care) was more likely to assist remotely during the pandemic (24.8% vs 12.1%; p < 0.001).ConclusionsBedside innovations, programmatic adaptations, and institutional support made it possible for healthcare workers to continue the 3 Wishes Program and provide compassionate end-of-life care in the ICU during this pandemic.

Published
2021

27. Expanding the 3 Wishes Project for compassionate end-of-life care: a qualitative evaluation of local adaptations

Author

Vanstone, Meredith, Neville, Thanh H, Swinton, Marilyn E, Sadik, Marina, Clarke, France J, LeBlanc, Allana, Tam, Benjamin, Takaoka, Alyson, Hoad, Neala, Hancock, Jennifer, McMullen, Sarah, Reeve, Brenda, Dechert, William, Smith, Orla M, Sandhu, Gyan, Lockington, Julie, and Cook, Deborah J

Subjects
Health Services and Systems, Health Sciences, Health Services, Clinical Research, Adult, Aged, Empathy, Female, Humans, Male, Middle Aged, Qualitative Research, Terminal Care, Intensive care unit, End of life care, Program evaluation, Qualitative research, Nursing, Public Health and Health Services, Gerontology, Health services and systems
Abstract

BackgroundThe 3 Wishes Project (3WP) is an end-of-life program that honors the dignity of dying patients by fostering meaningful connections among patients, families, and clinicians. Since 2013, it has become embedded in the culture of end-of-life care in over 20 ICUs across North America. The purpose of the current study is to describe the variation in implementation of 3WP across sites, in order to ascertain which factors facilitated multicenter implementation, which factors remain consistent across sites, and which may be adapted to suit local needs.MethodsUsing the methodology of qualitative description, we collected interview and focus group data from 85 clinicians who participated in the successful initiation and sustainment of 3WP in 9 ICUs. We describe the transition between different models of 3WP implementation, from core clinical program to the incorporation of various research activities. We describe various sources of financial and in-kind resources accessed to support the program.ResultsBeyond sharing a common goal of improving end-of-life care, sites varied considerably in organizational context, staff complement, and resources. Despite these differences, the program was successfully implemented at each site and eventually evolved from a clinical or research intervention to a general approach to end-of-life care. Key to this success was flexibility and the empowerment of frontline staff to tailor the program to address identified needs with available resources. This adaptability was fueled by cross-pollination of ideas within and outside of each site, resulting in the establishment of a network of like-minded individuals with a shared purpose.ConclusionsThe successful initiation and sustainment of 3WP relied on local adaptations to suit organizational needs and resources. The semi-structured nature of the program facilitated these adaptations, encouraged creative and important ways of relating within local clinical cultures, and reinforced the main tenet of the program: meaningful human connection at the end of life. Local adaptations also encouraged a team approach to care, supplementing the typical patient-clinician dyad by explicitly empowering the healthcare team to collectively recognize and respond to the needs of dying patients, families, and each other.Trial registrationNCT04147169 , retrospectively registered with clinicaltrials.gov on October 31, 2019.

Published
2020

28. Health economic evaluation alongside the Probiotics to Prevent Severe Pneumonia and Endotracheal Colonization Trial (E-PROSPECT): a cost-effectiveness analysis

Author

Lau, Vincent I., Xie, Feng, Fowler, Robert A., Rochwerg, Bram, Johnstone, Jennie, Lauzier, François, Marshall, John C., Basmaji, John, Henderson, William, Khwaja, Kosar, Loubani, Osama, Niven, Daniel J., Zarychanski, Ryan, Arabi, Yaseen M., Cartin-Ceba, Rodrigo, Thabane, Lehana, Heels-Ansdell, Diane, and Cook, Deborah J.

Published
2022
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29. Definitions, rates and associated mortality of ICU-acquired pneumonia: A multicenter cohort study

Author

Johnstone, Jennie, Muscedere, John, Dionne, Joanna, Duan, Erick, Rochwerg, Bram, Centofanti, John, Oczkowski, Simon, Lauzier, Francois, Marshall, John, Heels-Ansdell, Diane, Daneman, Nick, Mehta, Sangeeta, Arabi, Yaseen, Zytaruk, Nicole, Dodek, Peter, Adhikari, Neill K., Karachi, Tim, Charbonney, Emmanuel, Stelfox, Henry T., Kristof, Arnold S., Ball, Ian, Hand, Lori, Fowler, Rob, Zarychanski, Ryan, Arnaud, Charles St, Takaoka, Alyson, Kutsogiannis, James, Khwaja, Kosar, Sligl, Wendy, Loubani, Osama, Tsang, Jennifer, Lamarche, Daphnee, Bowdish, Dawn, Surette, Michael, and Cook, Deborah

Published
2023
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31. IV Vitamin C in Adults With Sepsis: A Bayesian Reanalysis of a Randomized Controlled Trial*

Author

Angriman, Federico, Muttalib, Fiona, Lamontagne, François, Adhikari, Neill K. J., Chassé, Michaël, Aslanian, Pierre, Bélisle, Sylvain, Cailhier, Jean-François, Carrier, François Martin, Charbonney, Emmanuel, Denault, André, Girard, Martin, Guimond, Jean-Gilles, Halwagi, Antoine, Hébert, Paul, Kolan, Christophe, Ouellet, Caroline, Robillard, Nicholas, Benettaib, Fatna, Boumahni, Dounia, Lebrasseur, Martine, Salamé, Maya, Cantin, Marie-Ève, Archambault, Patrick, Drouin, Christine, Dubé, Jean-Nicolas, Bériault, Marie-Josée, Chacon, Marco, Claveau, David, Naud, Jean-François, Rodrigue, Élise, Ting Wang, Han, Brosseau, Marc, Laufer, Brian, Marquis, François, Toupin, Francis, Lamontagne, François, D’Aragon, Frédérick, Bérard, Dominique, Grondin-Beaudoin, Brian, Leclair, Marc-André, Lesur, Olivier, Mayette, Michaël, Poulin, Yannick, Quiroz Martinez, Hector, St-Arnaud, Charles, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Duquet-Deblois, Estel, Noël-Hunter, Monia, Tapss, Danielle, Toupin, Guylaine, Tassy, Danaë, Cheung, Vincent, Toun, Sam-Ang, Carbonneau, Elaine, Bélisle, Julie, Bouchard, Marie-Pier, Côté, Line, Ladouceur, Marylène, Marchand, Joannie, Naisby, Alexandra, Robert-Petit, Louise, Thibault, Marie-Ève, Williams, Virginie, Lainer Palacios, Julia, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Lauzier, François, Francoeur, Charles, Leblanc, Guillaume, St-Onge, Maude, Turgeon, Alexis, Belley-Côté, Emilie, Fox-Robichaud, Alison, Meade, Maureen, Whitlock, Richard, Lellouche, François, Simon, Mathieu, Tung Sia, Ying, Rochwerg, Bram, Maslove, David, Gordon Boyd, J., Drover, John, Muscedere, John, Sibley, Stephanie, Mele, Tina, Shahin, Jason, Khwaja, Kosar, Mehta, Sangeeta, Detsky, Michael, Kohli, Sonny, Cui, Fulan, Khera, Vikas, McConachie, David, Rehsia, Sachdeep, James Kutsogiannis, Demetrios, Chowdhury, Raiyan, Davidow, Jon, Johnston, Curtis, Kim, Michael, Macala, Kimberley, Marcushamer, Sam, Markland, Darren, Matheson, Doug, Parker, Arabesque, Paton-Gay, Damian, Cook, Deborah, Al-Hazzani, Waleed, Duan, Erick, Ligori, Tania, Soth, Mark, Adhikari, Neill KJ, Amaral, Andre, Cuthbertson, Brian H, Fowler, Robert A, Piquette, Dominique, Scales, Damon C, Tillmann, Bourke, Wunsch, Hannah, Seely, Andrew, English, Shane, Meggison, Hilary, Microys, Sherissa, Millington, Scott, Sarti, Aimee, Del Sorbo, Lorenzo, Fan, Eddy, Granton, John, Rewa, Oleksa, Bagshaw, Sean, Meier, Michael, Sligl, Wendy, Wood, Gordon, Ovakim, Daniel, Leblanc, Rémi, Poirier, Matthieu, Theriault, Theophile, Williston, Maryse, Bellemare, David, Boulanger, Marie-Claude, Cloutier, Eve, Guilbault, Gabrielle, Thibeault, Frédérique, Hand, Lori, Hayward, Leah, Mullen, Courtney, Savija, Nevena, Lizotte, Patricia, Millen, Tina, Boyd, Tracy, Hunt, Miranda, Bentall, Tracey, ElKhatib, Chadia, Campisi, Josie, Alam, Norine, Rahgoshai, Raham, Shah, Sumesh, Bharti, Dalisha, Perez, Adic, Hewer, Tayne, Thompson, Patrica, Clarke, France, Copland, Mary, Matic, Karlo, Marinoff, Nicole, Kamra, Maneesha, Kaur, Navjot, Murali, Deeptha, Sabananthan, Thivya, Sugumaran, Thuva, Haines, Jessica, Miezitis, Sydney, Porteous, Rebecca, Watpool, Irene, Abdelhady, Hesham, Romagnuolo, Tina, Baig, Nadia, Auld, Fiona, Carney, Gayle, Parfett, Deborah, Caissie Collette, Jackie, Carriere, Melanie, Daigle, Melissa, Gaudet, Bernise, Morin, Karine, Ouellette-Bernier, Lola, Poitras, Julie, Robichaud, Melanie, Rockburn, Joanne, Mekontso Dessap, Armand, Arrestier, Romain, Bagate, François, Bendib, Ines, Benelli, Brice, Berti, Enora, Bertier, Astrid, Cavaleiro, Pedro, de Prost, Nicolas, Gendreau, Segolene, Hartman, Otto, Haudebourg, Anne-Fleur, Lopinto, Julien, Masi, Paul, Michaud, Gaël, Razazi, Keyvan, Tuffet, Samuel, Annane, Djillali, Abdeladim, Lilia, Bounab, Rania, Heming, Nicholas, Maxime, Virginie, Moine, Pierre, Alves, Aline, Nait Chabane, Luiza, Ouali, Fariza, Ouedraogo, Rachida, Bossard, Isabelle, Jourdier, Segolene, Mahiou, Siline, Tessa, Hayette, McGuinness, Shay, Ball, Jonathan, Hennessy, Immanuel, Hogan, Maurice, Van Der Poll, Andrew, Benson-Cooper, Kerry, Chen, Jonathan, Freeman, Kirk, Harley, David, Harvey, Dave, Hourigan, Craig, Julian, Kylie, Lo, Stephen, McArthur, Colin, Miller, Stuart, Pointer, Chris, Anthony Smith, Rex, Tincknell, Laura, Shaw, Geoffrey, Betteridge, Toby, Burke, Brandon, Closey, David, Crombie, Rosalind, Davidson, Neil, Henderson, Louise, Henderson, Seton, Hitchings, Louise, Knight, David, Quigley, Christine, Ritzema Carter, Jay, Roberts, Jessica, Townend, Katherine, Twardowski, Pawel, Dvoracek, Martin, Renner, Markus, Silverman, David, Smith, Myles, Monica Stephens, Katherine, Albert Waibel, Hansjörg, Wiebe, Stefan, Woolley, Mark, Buehner, Ulrike, Kramer, Katallah, Browne, Troy, Callender, Owen, Chen, Jonathan, Farrell, Susanne, Higson, Vicky, Jackson, David, Keet, Owen, Martynoga, Robert, Byrne, Kelly, Young, Paul, Barnes, Colin, Barry, Ben, Grayson, Kim, Moore, James, Psirides, Alex, Sturland, Shawn, Tietjens, Kate, Ure, Bob, Walker, Laurence, Wright, Jason, Butler, Magdalena, Cowdrey, Keri-Anne, Gilder, Eileen, Parke, Rachael, Ryan, Samantha, Woollett, Melissa, McConnochie, Rachael, Simmonds, Catherine, Doyle, Tara, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Van Der Heyden, Kymbalee, Eden, Amie, France, Dawn, Williams, Erin, Goodson, Jennifer, Butler, Amelia, Trask, Kara, Mans, Gay, Termaat, Jonathan, Aguilar-Dano, April, Delaney, Kirsha, Lawrence, Cassie, Lesona, Mildred, Millington, Alexandra, Navarra, Leanlove, Olatunji, Shaanti, Cruz, Raulle Sol, Cruz, Rhoze Sol, Young, Chelsea, Day, Andrew, Cook, Deborah J, Guyatt, Gordon H, Sprague, Sheila, Cohen, Dian, Heyland, Daren K, Lamontagne, François, Masse, Marie-Hélène, Ménard, Julie, Adhikari, Neill KJ, Pinto, Ruxandra, Kanji, Salmaan, Battista, Marie-Claude, Annane, Djillali, Vijayaraghavan, Bharath Kumar Tirupakuzhi, McGuinness, Shay, Parke, Rachael, and Arabi, Yaseen

Published
2023
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32. Impact of restricted visitation policies during COVID-19 on critically ill adults, their families, critical care clinicians, and decision-makers: a qualitative interview study

Author

Fiest, Kirsten M., Krewulak, Karla D., Jaworska, Natalia, Spence, Krista L., Mizen, Sara J., Bagshaw, Sean M., Burns, Karen E. A., Cook, Deborah J., Fowler, Robert A., Olafson, Kendiss, Patten, Scott B., Rewa, Oleksa G., Rochwerg, Bram, Spence, Sean, West, Andrew, Stelfox, Henry T., and Parsons Leigh, Jeanna

Published
2022
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33. A Patient-Level Meta-Analysis of Intensive Glucose Control in Critically Ill Adults

Author

Adigbli, Derick, primary, Li, Yang, additional, Hammond, Naomi, additional, Chatoor, Richard, additional, Devaux, Anthony G., additional, Li, Qiang, additional, Billot, Laurent, additional, Annane, Djillali, additional, Arabi, Yaseen, additional, Bilotta, Federico, additional, Bohé, Julien, additional, Brunkhorst, Frank Martin, additional, Cavalcanti, Alexandre Biasi, additional, Cook, Deborah, additional, Engel, Christoph, additional, Green-LaRoche, Deborah, additional, He, Wei, additional, Henderson, William, additional, Hoedemaekers, Cornelia, additional, Iapichino, Gaetano, additional, Kalfon, Pierre, additional, de La Rosa, Gisela, additional, Lahooti, Afsaneh, additional, Mackenzie, Iain, additional, Mahendran, Sajeev, additional, Mélot, Christian, additional, Mitchell, Imogen, additional, Oksanen, Tuomas, additional, Polli, Federico, additional, Preiser, Jean-Charles, additional, Garcia Soriano, Francisco, additional, Vlok, Ruan, additional, Wang, Lingcong, additional, Xu, Yuan, additional, Delaney, Anthony P., additional, Di Tanna, Gian Luca, additional, and Finfer, Simon, additional

Published
2024
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34. Early In-Bed Cycle Ergometry in Mechanically Ventilated Patients

Author

Kho, Michelle E., primary, Berney, Susan, additional, Pastva, Amy M., additional, Kelly, Laurel, additional, Reid, Julie C., additional, Burns, Karen E. A., additional, Seely, Andrew J., additional, D’Aragon, Frédérick, additional, Rochwerg, Bram, additional, Ball, Ian, additional, Fox-Robichaud, Alison E., additional, Karachi, Tim, additional, Lamontagne, Francois, additional, Archambault, Patrick M., additional, Tsang, Jennifer L., additional, Duan, Erick H., additional, Muscedere, John, additional, Verceles, Avelino C., additional, Serri, Karim, additional, English, Shane W., additional, Reeve, Brenda K., additional, Mehta, Sangeeta, additional, Rudkowski, Jill C., additional, Heels-Ansdell, Diane, additional, O’Grady, Heather K., additional, Strong, Geoff, additional, Obrovac, Kristy, additional, Ajami, Daana, additional, Camposilvan, Laura, additional, Tarride, Jean-Eric, additional, Thabane, Lehana, additional, Herridge, Margaret S., additional, and Cook, Deborah J., additional

Published
2024
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47. Multistudy Research Operations in the ICU: An Interprofessional Pandemic-Informed Approach

Author

Cook, Deborah J., Duan, Erick H., Clarke, France J., Matic, Karlo, Culgin, Sarah, Kelly, Laurel, Nelson, Katlynne S., Wallace, Christine V., Soth, Mark D., Lewis, Kimberley A., Rudkowski, Jill C., Perri, Dan, Ligori, Tania L., Jaeschke, Roman Z., Chagla, Zain, Chaudhuri, Dipayan, Wright, Angela E., Fu, Zoe Y., Reeve, Brenda K., Lee, Hilary M., Overington, Jeffrey D., Rozenberg, Anna, Bloomfield, Kimberly A., Love, Katryn, Gain, Jennifer L., Zytaruk, Nicole L., Cheung, Jason H., Thabane, Lehana, Kho, Michelle E., Alhazzani, Waleed, Bell, Matthew, Bloomfield, Kimberley, Chagla, Zain, Chaudhuri, Dipayan, Cheung, Jason, Clarke, France, Cook, Deborah, Copland, Mary, Culgin, Sarah, Duan, Erick, Fu, Zoe, Gain, Jennifer, Hurd, Abby, Jaeschke, Roman, Lee, Hilary, Love, Katryn, Kelly, Laurel, Kho, Michelle, Kim, Kate, Lewis, Kimberley, Ligori, Tania, Matic, Karlo, Nelson, Katlynne, O‘Grady, Heather, Overington, Jeffrey, Perri, Dan, Reeve, Brenda, Rozenberg, Anna, Rudkowski, Jill, Saunders, Lois, Semrau, Joanna, Soth, Mark, Wallace, Christine, Waugh, Lily, Wright, Angela, and Zytaruk, Nicole

Published
2022
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48. Diarrhea during critical illness: a multicenter cohort study

Author

Dionne, Joanna C., Mbuagbaw, Lawrence, Devlin, John W., Duprey, Matthew S., Cartin-Ceba, Rodrigo, Tsang, Jennifer, Sullivan, Kristen, Muscedere, John, Alshahrani, Mohammed, Szczeklik, Wojciech, Lysecki, Paul, Takaoka, Alyson, Reeve, Brenda, Campbell, Tracy, Borowska, Karolina, Serednicki, Wojciech, Cirone, Robert, Alhazzani, Waleed, Moayyedi, Paul, Armstrong, David, Thabane, Lehana, Jaeschke, Roman, Hamielec, Cindy, Karachi, Tim, and Cook, Deborah J.

Published
2022
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50. Research interrupted: applying the CONSERVE 2021 Statement to a randomized trial of rehabilitation during critical illness affected by the COVID-19 pandemic

Author

Reid, Julie C., Molloy, Alex, Strong, Geoff, Kelly, Laurel, O’Grady, Heather, Cook, Deborah, Archambault, Patrick M., Ball, Ian, Berney, Sue, Burns, Karen E. A., D’Aragon, Frederick, Duan, Erick, English, Shane W., Lamontagne, François, Pastva, Amy M., Rochwerg, Bram, Seely, Andrew J. E., Serri, Karim, Tsang, Jennifer L. Y., Verceles, Avelino C., Reeve, Brenda, Fox-Robichaud, Alison, Muscedere, John, Herridge, Margaret, Thabane, Lehana, and Kho, Michelle E.

Published
2022
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