{"id":19235,"date":"2018-10-30T10:35:04","date_gmt":"2018-10-30T16:35:04","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=19235"},"modified":"2022-06-03T11:04:28","modified_gmt":"2022-06-03T17:04:28","slug":"uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/","title":{"rendered":"UCHealth pilot: Involving patients and family early on in plan of care"},"content":{"rendered":"
<\/div>

On a Friday afternoon in mid-September, Larry Batman lay in a bed in the Cardiac Intensive Care Unit (CICU) at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus. He\u2019d been in the hospital for six weeks, a challenging stay that was not yet over. But the journey to UCH started nearly two decades earlier on a stretch of road in Colorado Springs.<\/p>\n

In 2000, Batman, then 51, was driving east on Woodmen Road in an Acura Integra when the driver of an SUV traveling in the opposite direction unexpectedly made a U turn in the middle of the road. Batman crashed into the SUV. He suffered a shattered leg and other traumatic injuries, including fractures of his ribs, wrists, shoulders, elbows and a badly bruised his heart.<\/p>\n

\"A
Larry Batman with his three-wheel bike, which he rode regularly prior to surgery to implant an LVAD. Batman spent weeks at University of Colorado Hospital in intensive care. Photo courtesy of Karen Batman.<\/figcaption><\/figure>\n

The crash sent Batman to a hospital intensive care unit for 10 days, but the damage was lasting, his wife Karen related. He needed a defibrillator and pacemaker to manage erratic heart rhythms. In 2003, he had surgery to repair a mitral valve worn out from the strain.<\/p>\n

Despite the ordeal, Batman stayed active. After 37 years in the Springs, he and Karen moved to tiny Iliff (population 236) in northeast Colorado in 2015. There, Larry built a two-story barn, rode his motorized three-wheel bike, maintained a long hobby of restoring Model A Fords and served as an on-site supervisor for Iliff\u2019s construction of a wastewater plant.<\/p>\n

\u201cHe walked the site every day from 6:30 a.m. to 2:30 p.m.,\u201d Karen recalled.<\/p>\n

Critical turn<\/strong><\/h3>\n

But in February 2018, Larry\u2019s battle with heart disease entered a new phase. His cardiologist in Sterling, worried that his condition had worsened, referred him to the Cardiac and Vascular Center<\/a> at UCH. In late June, Larry spent a week at UCH to rid his body of water that accumulated because his heart was weakening. In July, he was back for the same reason when new and shocking news arrived: a specialist from the Heart Failure Clinic<\/a> approached the Batmans to present them information about a left ventricular assist device (LVAD), which provides mechanical circulatory support for a badly diminished heart.<\/p>\n

The couple was taken aback. \u201cWe said, \u2018What is this? Why are we looking at this?\u2019\u201d Karen said.<\/p>\n

Dr. Jay Pal, surgical director of UCH\u2019s Mechanical Circulatory Support Program, helped them to absorb the shocking news that without an LVAD, Larry probably had only six months to a year to live. But Pal also offered reassurance.<\/p>\n

\u201cDr. Pal had told us that Larry was a good candidate for the surgery and gave him the confidence to go ahead with it,\u201d Karen said. With that, Larry agreed to the LVAD surgery, postponing a planned trip to Orlando to see one of the Batmans\u2019 daughters.<\/p>\n

Pal performed the procedure successfully on Aug. 7, 2018. But Larry\u2019s problems weren\u2019t over. He required abdominal surgery to remove a section of intestine and had to go on dialysis for a time. His liver function also declined.<\/p>\n

\"Larry
Larry Batman poses before a two-story barn he built in Iliff, Colorado. Photo courtesy of Karen Batman.<\/figcaption><\/figure>\n

Intensive attention<\/strong><\/h3>\n

On that mid-September afternoon, Larry smiled weakly as he lie in his CICU bed and spoke briefly with a visitor. His ordeal, starkly described by Karen, struck home. But her vivid retelling underscored that injury and disease also inflicts pain and suffering on those who love and care for its victims.<\/p>\n

That recognition and the commitment to addressing it lie at the heart of an initiative at UCH. The \u201cICU Early Patient\/Family Engagement\u201d pilot, launched in the Cardiothoracic ICU (CTICU) about a year ago, is now underway in the Surgical Trauma ICU and will ultimately be in place in all the hospital\u2019s ICUs.<\/p>\n

The goals include identifying within 24 hours a \u201chealth care decision maker\u201d authorized to speak on behalf of the patient; holding a \u201cmeet and greet\u201d between the health care decision maker and the multidisciplinary ICU team to identify goals of care within 72 hours of admission; involving patients and family members in daily rounding by the care team; and consulting regularly with the Palliative Care team on difficult clinical cases.<\/p>\n

A <\/strong>complete team approach<\/strong><\/h3>\n

The commitment also includes membership for the hospital in the Center to Advance Palliative Care<\/a>, which provides educational modules available to all UCH staff, providers and learners who create an account.<\/p>\n

The project, which has the backing of UCHealth President and CEO Elizabeth B. Concordia and her senior leadership team, is designed \u201cto best meet the needs of critically ill patients and their families,\u201d said Dr. Jeanie Youngwerth<\/a>, director of the Palliative Care Service<\/a>\u00a0at UCH. In practice, that means ensuring that they have open channels to providers to communicate their values and goals of treatment \u2013 especially important for seriously ill patients who are intubated or sedated.<\/p>\n

\u201cMany patients in the ICU can\u2019t speak for themselves,\u201d Youngwerth said. \u201cWe want to make sure their voices are still heard.\u201d<\/p>\n

A quicker connection<\/strong><\/h3>\n

Those voices can get lost in the bustle of an ICU handling multiple complex cases. The early engagement pilot aims to reduce the inevitable anxiety of critically ill patients and families, said Dr. David Fullerton<\/a>, surgeon and chief of the Division of Cardiothoracic Surgery at the University of Colorado School of Medicine.<\/p>\n

\"\"
Batman in one of the Model A Fords he’\u0092s restored. Photo courtesy of Karen Batman.<\/figcaption><\/figure>\n

\u201cThese are potentially life-changing events for patients, but even more so for families. Very often there is absolutely no opportunity for families to prepare themselves mentally for the fact that their loved one is going to be in the ICU, very sick, for a protracted period of time. I think that by extending ourselves from the very beginning to those families, to make sure they know who we are, and who they can go to to seek help, we are providing an invaluable service.\u201d<\/p>\n

It is vital to identify a health care decision maker early in a patient\u2019s care, Fullerton added.<\/p>\n

\u201cIt is not rare that a person winds up in a critically ill situation very unexpectedly and before they establish a person with medical power of attorney,\u201d he said. The ICU initiative, he added, \u201cfacilitates the process of identifying that person before it is absolutely necessary to do so.\u201d<\/p>\n

Family ties<\/strong><\/h3>\n

The CTICU pilot has helped to \u201cnormalize\u201d interactions between the ICU team and patients and families related to identifying, and revisiting, goals of care, said Dr. Jean Kutner<\/a>, chief medical officer for UCH and a specialist in palliative care. One key element: establishing each service\u2019s social worker in the role of \u201cpoint person\u201d responsible for organizing the initial \u201cmeet and greet\u201d that acquaints the multidisciplinary care team with the patient\u2019s health care decision maker. She praised social work lead Emily Scott and the social work staff for filling that role.<\/p>\n

In the CTICU, it\u2019s handled by Matthew Stoffel. He said early meetings with family members are important to get them talking about goals of treatment, finalizing advance directives, designating medical power of attorney and other considerations pertinent to the patient.<\/p>\n

\u201cIt\u2019s an extra layer of communication to facilitate dialogue right away,\u201d Stoffel said. \u201cOverall, we try to give families comfort and reassurance with regard to the overall plan of care. Sometimes that\u2019s just a review of what\u2019s going on that they can process in a less stressful place.\u201d<\/p>\n

What’s success?<\/strong><\/h3>\n

Stoffel noted that the hospital has established outcomes measures for the pilot, including the percentage of cases in which a health care decision maker is documented by day one of the ICU admission; the percentage of patients whose goals of treatment have been identified by day three; the percentage of patients whose family has met with the multidisciplinary team by day three; and the percentage of patients with an advance directive in the Epic electronic health record by day five. But he added that he doesn\u2019t see the pilot\u2019s success determined by mere numbers.<\/p>\n

\u201cPositive feedback from families and patients is what I care about,\u201d he said. \u201cIf I\u2019m meeting folks and they\u2019re feeling supported and know I\u2019m there and can call me when things get rough and they\u2019re appreciative of staff, that\u2019s the important stuff for me.\u201d<\/p>\n

Beyond the clinical<\/strong><\/h3>\n
\"\"
Dr. Jean Kutner and her staff works in the Oncology department at the Anschutz Inpatient Pavilion. (Photo by Glenn Asakawa\/University of Colorado).<\/figcaption><\/figure>\n

John Karels, associate nurse manager of the CTICU, said the pilot has brought a \u201crenewed\u201d commitment to ensuring the unit addresses the concerns and questions of the patient and family just as consistently as it addresses each medical issue.<\/p>\n

\u201cIn the busyness of health care, we can get caught up in the belief that everyone is aware of the patient\u2019s plan of care,\u201d Karels said. \u201cWe may come to the bedside with what we believe are the patient\u2019s best interests in mind, but sometimes little points of communication between the health care provider and patients and families can get dropped or lost. We\u2019re refocusing on meeting the goals of the patient.\u201d<\/p>\n

Listening<\/strong><\/h3>\n

That approach is essential to creating an open culture in the ICU, something that can be difficult to do in a space where time is tight and pressure is high. As Fullerton noted, the CTICU and many other units at UCH frequently receive patients referred from other hospitals because their conditions have worsened.<\/p>\n

\u201cThey arrive to a completely new environment knowing that their loved one is critically ill,\u201d Fullerton said. \u201cIn those cases, it is particularly important to extend ourselves from the very outset, not only to introduce ourselves but to make sure that they know they are in a [place] that will be supportive of everything they need.\u201d<\/p>\n

For Michelle Feller, a registered nurse and director of critical care, cardiology and dialysis at UCH, the ICU initiative is \u201cforward thinking\u201d and an effort to make health care more transparent and collaborative. That requires listening, she said.<\/p>\n

\u201cWe have to make sure we know the details about family members\u2019 loved ones,\u201d Feller said. \u201cThat promotes individualized care. One person may have the same diagnosis as another, but how they respond to treatment is individual.\u201d<\/p>\n

Uncharted territory<\/strong><\/h3>\n

Karen Batman knew nothing of these internal decisions and discussions when Larry rolled into the CTICU following his LVAD surgery. The surgery had gone well, but now a long and challenging recovery lay ahead, one that was to be fraught with new medical concerns. Karen said the CTICU team quickly connected with her, making sure she was invited to join them during daily rounds and to ask questions.<\/p>\n

The back-and-forth between providers during rounds can sound like a foreign language to a non-medical person \u2013 a potential source of stress in and of itself. Karen said she didn\u2019t feel that.<\/p>\n

\u201cThere was always one doctor to fill in and put the discussion in layman\u2019s terms and tell me, \u2018Ok, this is the plan.\u2019 That went very well. They would also wait on the rounding to see when I was there.\u201d<\/p>\n

Nearly without exception, Karen added, she received consistent information about Larry\u2019s condition, regardless of who she spoke with.<\/p>\n

\"a
Cardiothoracic Surgery Chief Dr. David Fullerton stresses the importance to the initiative of identifying each ICU patient\u0092s health care decision maker early in the stay.<\/figcaption><\/figure>\n

\u201cIt gave me confidence to know that they all were looking at him as a team and that they were doing everything they possibly could to make him get well,\u201d she said. \u201cWe could understand what they were doing.\u201d<\/p>\n

Palliative care assist<\/strong><\/h3>\n

The Palliative Care team played a crucial role in helping the Batmans through the \u201croller coaster ride\u201d that followed the LVAD and abdominal surgeries, Karen said. \u201cThey started before surgery to explain their role and visited us in the unit,\u201d she said.<\/p>\n

That role was to help Larry identify his own goals for his care \u2013 ideas that might change during the course of his treatment. His experience illustrates how important palliative care is to the ICU patient\/family engagement initiative.<\/p>\n

Karen watched as Larry\u2019s surgeries and complications weakened him and sent him into decline, physically and emotionally.<\/p>\n

\u201cAt one point I thought my husband was about to give up with everything that had gone on,\u201d Karen recalled. She asked Harri Brackett, lead advance practice nurse for the Palliative Care Service, to speak with him, outside of Karen\u2019s presence, so he could express himself as honestly as possible.<\/p>\n

The line in the sand<\/strong><\/h3>\n

Brackett previously had helped Karen and Larry fill out a \u201cFive Wishes\u201d advance care booklet. In it, Larry identified his \u201cline in the sand,\u201d which was stopping treatment when he was no longer \u201ccognizant\u201d or \u201cinteractive,\u201d Brackett said.<\/p>\n

\u201cThat day when he and Karen were feeling so forlorn, I reminded them of that \u2013 especially Karen,\u201d Brackett said. \u201cHe was still able to be aware of things and interact and I told them, \u2018It wasn’t time yet,\u2019 and they needed to keep going, based on what he had said was his line in the sand.\u201d<\/p>\n

\u201cHarri told me that he still had that fight in him,\u201d Karen said.<\/p>\n

Music to the ears<\/strong><\/h3>\n

Another source of strength and inspiration was Angela Wibben, music therapist<\/a> with the Palliative Care team, Karen said. Wibben visited Larry in the CTICU, singing \u201cTeddy Bear\u201d with him to his granddaughter, an Elvis fan. After he transferred to the CICU, Wibben returned for another round of songs.<\/p>\n

\"A
Harri Brackett (right), lead advanced practice nurse for the Palliative Care Service, with director Dr. Jeanie Youngwerth, helped Batman and his wife Karen through a difficult recovery after LVAD surgery.<\/figcaption><\/figure>\n

\u201cShe told him, \u2018I\u2019m going to sing you out the door. I\u2019m going to sing you \u2018Happy Trails,\u2019\u201d Karen said. \u201cShe would light up his day.\u201d<\/p>\n

The bedrock goal of the ICU early engagement pilot is improved patient care. Kutner points out that \u201cthere is a growing body of evidence that having early family engagement leads to positive outcomes that are consistent with the goals and values of the patient.\u201d But of course true outcomes are measured in the lives of people like Larry and Karen Batman.<\/p>\n

By the first week of October, with his 70th<\/sup> birthday just days away, Larry had moved from the CICU to the Rehabilitation Medicine Unit at UCH, one more step toward regaining his life. He hoped to be home for his birthday. Karen said they were pointed to another goal.<\/p>\n

\u201cOur 50th<\/sup> anniversary is in December,\u201d she said. \u201cHe\u2019s going to make it.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

On a Friday afternoon in mid-September, Larry Batman lay in a bed in the Cardiac Intensive Care Unit (CICU) at UCHealth University of Colorado Hospital on the Anschutz Medical Campus. He\u2019d been in the hospital for six weeks, a challenging stay that was not yet over. But the journey to UCH started nearly two decades […]<\/p>\n","protected":false},"author":2143,"featured_media":19237,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[5],"tags":[154,4301],"class_list":["post-19235","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-innovative-care","tag-palliative-care","tag-uchealth-heart-and-vascular-center"],"acf":[],"yoast_head":"\nInvolving patients and family early on in plan of care - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Involving patients and family early on is the goal of a year-old pilot in the Cardiothoracic ICU at UCHealth's University of Colorado Hospital.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"UCHealth pilot: Involving patients and family early on in plan of care\" \/>\n<meta property=\"og:description\" content=\"Involving patients and family early on is the goal of a year-old pilot in the Cardiothoracic ICU at UCHealth's University of Colorado Hospital.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/\" \/>\n<meta property=\"og:site_name\" content=\"UCHealth Today\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uchealthorg\/\" \/>\n<meta property=\"article:published_time\" content=\"2018-10-30T16:35:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-06-03T17:04:28+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/10\/30102410\/EXT_10818_Batman-Bike.jpgeee.jpg\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Tyler Smith\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@uchealth\" \/>\n<meta name=\"twitter:site\" content=\"@uchealth\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Tyler Smith\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"12 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/\"},\"author\":{\"name\":\"Tyler Smith\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/98c85c0e40c4933eedcec2cd054f349d\"},\"headline\":\"UCHealth pilot: Involving patients and family early on in plan of care\",\"datePublished\":\"2018-10-30T16:35:04+00:00\",\"dateModified\":\"2022-06-03T17:04:28+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/\"},\"wordCount\":2510,\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2018\\\/10\\\/30102410\\\/EXT_10818_Batman-Bike.jpgeee.webp\",\"keywords\":[\"Palliative care\",\"UCHealth Heart and Vascular Center\"],\"articleSection\":[\"Innovative care\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/\",\"name\":\"Involving patients and family early on in plan of care - UCHealth Today\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2018\\\/10\\\/30102410\\\/EXT_10818_Batman-Bike.jpgeee.webp\",\"datePublished\":\"2018-10-30T16:35:04+00:00\",\"dateModified\":\"2022-06-03T17:04:28+00:00\",\"description\":\"Involving patients and family early on is the goal of a year-old pilot in the Cardiothoracic ICU at UCHealth's University of Colorado Hospital.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#primaryimage\",\"url\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2018\\\/10\\\/30102410\\\/EXT_10818_Batman-Bike.jpgeee.webp\",\"contentUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2018\\\/10\\\/30102410\\\/EXT_10818_Batman-Bike.jpgeee.webp\",\"width\":1200,\"height\":675,\"caption\":\"Larry Batman with his three-wheel bike, which he rode regularly prior to surgery to implant an LVAD. Batman spent weeks at University of Colorado Hospital in intensive care. Photo courtesy of Karen Batman.\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"UCHealth pilot: Involving patients and family early on in plan of care\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#website\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/\",\"name\":\"UCHealth Today\",\"description\":\"UCHealth Today\",\"publisher\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#organization\",\"name\":\"UCHealth\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2020\\\/04\\\/24135149\\\/UCHealth-square-logo-1000x1000-1.jpg\",\"contentUrl\":\"https:\\\/\\\/uchealth-wp-uploads.s3.amazonaws.com\\\/wp-content\\\/uploads\\\/sites\\\/6\\\/2020\\\/04\\\/24135149\\\/UCHealth-square-logo-1000x1000-1.jpg\",\"width\":1000,\"height\":1000,\"caption\":\"UCHealth\"},\"image\":{\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/uchealthorg\\\/\",\"https:\\\/\\\/x.com\\\/uchealth\",\"https:\\\/\\\/www.instagram.com\\\/uchealth\\\/\",\"https:\\\/\\\/www.linkedin.com\\\/school\\\/14839\\\/\",\"https:\\\/\\\/www.pinterest.com\\\/uchealthorg\\\/\",\"https:\\\/\\\/www.youtube.com\\\/channel\\\/UC41SJI79yjZIe96OajzN22g\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/#\\\/schema\\\/person\\\/98c85c0e40c4933eedcec2cd054f349d\",\"name\":\"Tyler Smith\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/d9cf06f094860ff4c88dfe85d3c79a05724744cb3f865253e7b928d904aaad8e?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/d9cf06f094860ff4c88dfe85d3c79a05724744cb3f865253e7b928d904aaad8e?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/d9cf06f094860ff4c88dfe85d3c79a05724744cb3f865253e7b928d904aaad8e?s=96&d=mm&r=g\",\"caption\":\"Tyler Smith\"},\"description\":\"Tyler Smith has been a health care writer, with a focus on hospitals, since 1996. He served as a writer and editor for the Marketing and Communications team at University of Colorado Hospital and UCHealth from 2007 to 2017. More recently, he has reported for and contributed stories to the University of Colorado School of Medicine, the Colorado School of Public Health and the Colorado Bioscience Association.\",\"url\":\"https:\\\/\\\/www.uchealth.org\\\/today\\\/author\\\/smiths3\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Involving patients and family early on in plan of care - UCHealth Today","description":"Involving patients and family early on is the goal of a year-old pilot in the Cardiothoracic ICU at UCHealth's University of Colorado Hospital.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/","og_locale":"en_US","og_type":"article","og_title":"UCHealth pilot: Involving patients and family early on in plan of care","og_description":"Involving patients and family early on is the goal of a year-old pilot in the Cardiothoracic ICU at UCHealth's University of Colorado Hospital.","og_url":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/","og_site_name":"UCHealth Today","article_publisher":"https:\/\/www.facebook.com\/uchealthorg\/","article_published_time":"2018-10-30T16:35:04+00:00","article_modified_time":"2022-06-03T17:04:28+00:00","og_image":[{"url":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/10\/30102410\/EXT_10818_Batman-Bike.jpgeee.jpg","type":"image\/jpeg"}],"author":"Tyler Smith","twitter_card":"summary_large_image","twitter_creator":"@uchealth","twitter_site":"@uchealth","twitter_misc":{"Written by":"Tyler Smith","Est. reading time":"12 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#article","isPartOf":{"@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/"},"author":{"name":"Tyler Smith","@id":"https:\/\/www.uchealth.org\/today\/#\/schema\/person\/98c85c0e40c4933eedcec2cd054f349d"},"headline":"UCHealth pilot: Involving patients and family early on in plan of care","datePublished":"2018-10-30T16:35:04+00:00","dateModified":"2022-06-03T17:04:28+00:00","mainEntityOfPage":{"@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/"},"wordCount":2510,"publisher":{"@id":"https:\/\/www.uchealth.org\/today\/#organization"},"image":{"@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#primaryimage"},"thumbnailUrl":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/10\/30102410\/EXT_10818_Batman-Bike.jpgeee.webp","keywords":["Palliative care","UCHealth Heart and Vascular Center"],"articleSection":["Innovative care"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/","url":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/","name":"Involving patients and family early on in plan of care - UCHealth Today","isPartOf":{"@id":"https:\/\/www.uchealth.org\/today\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#primaryimage"},"image":{"@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#primaryimage"},"thumbnailUrl":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/10\/30102410\/EXT_10818_Batman-Bike.jpgeee.webp","datePublished":"2018-10-30T16:35:04+00:00","dateModified":"2022-06-03T17:04:28+00:00","description":"Involving patients and family early on is the goal of a year-old pilot in the Cardiothoracic ICU at UCHealth's University of Colorado Hospital.","breadcrumb":{"@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#primaryimage","url":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/10\/30102410\/EXT_10818_Batman-Bike.jpgeee.webp","contentUrl":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2018\/10\/30102410\/EXT_10818_Batman-Bike.jpgeee.webp","width":1200,"height":675,"caption":"Larry Batman with his three-wheel bike, which he rode regularly prior to surgery to implant an LVAD. Batman spent weeks at University of Colorado Hospital in intensive care. Photo courtesy of Karen Batman."},{"@type":"BreadcrumbList","@id":"https:\/\/www.uchealth.org\/today\/uchealth-pilot-involving-patients-and-family-early-on-in-plan-of-care\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.uchealth.org\/today\/"},{"@type":"ListItem","position":2,"name":"UCHealth pilot: Involving patients and family early on in plan of care"}]},{"@type":"WebSite","@id":"https:\/\/www.uchealth.org\/today\/#website","url":"https:\/\/www.uchealth.org\/today\/","name":"UCHealth Today","description":"UCHealth Today","publisher":{"@id":"https:\/\/www.uchealth.org\/today\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.uchealth.org\/today\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/www.uchealth.org\/today\/#organization","name":"UCHealth","url":"https:\/\/www.uchealth.org\/today\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.uchealth.org\/today\/#\/schema\/logo\/image\/","url":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/24135149\/UCHealth-square-logo-1000x1000-1.jpg","contentUrl":"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2020\/04\/24135149\/UCHealth-square-logo-1000x1000-1.jpg","width":1000,"height":1000,"caption":"UCHealth"},"image":{"@id":"https:\/\/www.uchealth.org\/today\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/uchealthorg\/","https:\/\/x.com\/uchealth","https:\/\/www.instagram.com\/uchealth\/","https:\/\/www.linkedin.com\/school\/14839\/","https:\/\/www.pinterest.com\/uchealthorg\/","https:\/\/www.youtube.com\/channel\/UC41SJI79yjZIe96OajzN22g"]},{"@type":"Person","@id":"https:\/\/www.uchealth.org\/today\/#\/schema\/person\/98c85c0e40c4933eedcec2cd054f349d","name":"Tyler Smith","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/d9cf06f094860ff4c88dfe85d3c79a05724744cb3f865253e7b928d904aaad8e?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/d9cf06f094860ff4c88dfe85d3c79a05724744cb3f865253e7b928d904aaad8e?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/d9cf06f094860ff4c88dfe85d3c79a05724744cb3f865253e7b928d904aaad8e?s=96&d=mm&r=g","caption":"Tyler Smith"},"description":"Tyler Smith has been a health care writer, with a focus on hospitals, since 1996. He served as a writer and editor for the Marketing and Communications team at University of Colorado Hospital and UCHealth from 2007 to 2017. More recently, he has reported for and contributed stories to the University of Colorado School of Medicine, the Colorado School of Public Health and the Colorado Bioscience Association.","url":"https:\/\/www.uchealth.org\/today\/author\/smiths3\/"}]}},"coauthors":[{"id":2143,"name":"Tyler Smith","link":"https:\/\/www.uchealth.org\/today\/author\/smiths3\/"}],"_links":{"self":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts\/19235","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/users\/2143"}],"replies":[{"embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/comments?post=19235"}],"version-history":[{"count":10,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts\/19235\/revisions"}],"predecessor-version":[{"id":64173,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts\/19235\/revisions\/64173"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/media\/19237"}],"wp:attachment":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/media?parent=19235"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/categories?post=19235"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/tags?post=19235"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}