Episode 51 - Dr. Jean Kutner: The Evolution of Evidence-Based Practice in Hospice

Monday, July 26, 2010, 10:06:34 AM

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In this episode, Dr. Jean Kutner discusses the history and role of evidence-based practice in hospice care, changes in hospice care, and barriers and facilitators to building an evidence base.

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Average Rating: 4.2 stars (5 listener reviews )

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Average Rating: 4stars  evidence or experience?, Monday, January 30, 2012

By David B. :

I love listening to and being involved in conversations regarding evidence-based practice, because I find that it can be a complex topic with many different angles. It was especially enjoyable to hear Dr. Kutner's thoughts due to her wealth of experience in hospice. To me, evidence-based practice is essential because it goes a long way in eliminating human error and assumptions when providing care. I think Dr. Kutner identified the struggle of gathering evidence without exploiting the vulnerable state of patients. I can't help but feel that in the process of conducting studies, that we are dehumanizing those that we are trying to help. Also, though evidence-based practice is essential to providing proper care, I wouldn't eliminate the use of the experience of professionals. I sometimes feel that relying strictly on evidence can be too rigid and that unique situations can benefit from the experience of a seasoned care-worker. Nonetheless, Dr. Kutner touched on the fact that patients and their situations are becoming more complex over time. It only makes sense to cultivate evidence-based practice in order to deal with this difficulty.

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Average Rating: 4stars  hospice, Tuesday, January 17, 2012

By Shelsy Napoleon :

In the podcast, Dr. Jean Kutner says that hospice care has gotten more complex. Hospice has started using electronic devices to monitor the records for the patients. I have noticed the use of electronics within the medical field as well. Dr. Kutner does an amazing job describing how the academic setting of the university and hospice are working together to gather an evidence-based research for the patients.

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Average Rating: 4stars  review, Wednesday, January 11, 2012

By Kyle Jahn :

I found this review very interesting and informative. I believe hospice care is very beneficial in comforting those in need as well as their families. It is sad that there is so much gate keeping that stands between furthering research in this field. I also agree with the fact that hospices need to interact and compare data since there is such a limited amount. Thanks for your work in this field.

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Average Rating: 5stars  incorporating evidence based practice in hospice, Wednesday, October 12, 2011

By Anonymous :

I thought this was an interesting and information podcast. It was interesting to hear how Hospice was and how it is headed in the direction of evidence-based practice. This is good to hear as evidence-based models provide the most up to date information for care of patients. The part I found really interesting and informative is how Hospice is trying to use evidence to develop ways to work with this population of patients, but yet this field seems to be primarily based on experience not evidence. It was also interesting to note that only 40% of the Hospice population is cancer patients because earlier that is what I thought was the general population of Hospice. It is great to see that Hospice is also helping other populations. It was also great to hear that many families actually want to participate in research for Hospice. This is definitely a great pathway for evidence-based practice. I was not aware of that before. I also thought it was a great idea that was introduced of how all staff in Hospice should be engaged beginning at the top with the C.E.O and all the way down the staff. I think that is the best way to provide services for any population, when all staff including the very top are engaged in evidence-based practice and helping the population. I did find it interesting how it was stated that “it was a rocky road between Hospice and universities”. I am glad to hear that they are starting to come together, as universities are where a lot of future staff of Hospice will come from. It was also good to hear that more interest is being shown for the specific field of Hospice and Palliative care. This is also great to hear because if universities and Hospice collaborate effectively and use evidence-based practice, it will create the best form of care and comfort for the patient and their families.

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Average Rating: 4stars  podcast 51 review, Tuesday, January 25, 2011

By Corinne Miga :

I enjoyed learning the progress of hospice by Dr. Jean Kutner, of the University of Colorado Denver, who is certified and active in research of Hospice and Palliative medicine. She discussed the evolution of evidence-based practice at Hospice. Originally, Hospice cared for cancer patients and helped some with pain management, but its grown to be more complex. Dr. Kutner explained that an increase in the complexity of patients’ overtime, caused a specialty to be developed in the field. For this specialty to become a certification, there needed to be evidence—a demonstrated body of knowledge and an increase in accountability. It is hard to find evidence for Hospice care because patients are typically very sick, often die relatively quickly, or may be mentally incapable of providing data. There is a great deal of gatekeeping due to this vulnerability, making it hard to research. Beyond the lack of evidence-based practice, cultural barriers also exist; Hospice is a very caring organization and strives to be sensitive to each patient’s background and beliefs. Therefore, bringing in outside expertise is a challenge, so research is being incorporated on a day to day basis. While evidence based practices are difficult to come about, a growing interest in this field exists.
Collaboration among all Hospice employees, from various levels and locations, is vital in obtaining evidence. Comparing multiple family responses along with universal standards is best for supporting which practices are successful and which are not. Hospitals and universities can work together as partners; Hospice brings the day to day research and observations, and universities can analyze and implement this information, and provide expertise. I think it is important to continue to develop research and evidence from a collaborative of hospitals and universities to determine the most dignified and comfortable form of care as patients fight to accept the reality of death in their life.

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