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  1. Article ; Online: Error in Number of Eligible Patients in Survey of Self-reported Prognostic Expectations of People Undergoing Dialysis.

    O'Hare, Ann M

    JAMA internal medicine

    2021  Volume 181, Issue 9, Page(s) 1264–1265

    MeSH term(s) Humans ; Motivation ; Prognosis ; Renal Dialysis ; Self Report ; Surveys and Questionnaires
    Language English
    Publishing date 2021-07-09
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2699338-7
    ISSN 2168-6114 ; 2168-6106
    ISSN (online) 2168-6114
    ISSN 2168-6106
    DOI 10.1001/jamainternmed.2021.3259
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  2. Article ; Online: How Useful Is an Age-Neutral Model of Chronic Kidney Disease?

    O'Hare, Ann M

    JAMA network open

    2020  Volume 3, Issue 9, Page(s) e2017592

    MeSH term(s) Adult ; Canada ; Humans ; Kidney ; Renal Insufficiency ; Renal Insufficiency, Chronic/epidemiology
    Language English
    Publishing date 2020-09-01
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2020.17592
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  3. Article ; Online: Dialysis adequacy reconsidered: The person comes first.

    O'Hare, Ann M

    Seminars in dialysis

    2020  Volume 33, Issue 6, Page(s) 486–489

    Abstract: Although many nephrologists see value in maximizing clearance and time on dialysis, clinical trials have failed to show a clear and consistent benefit of increasing clearance above the minimum threshold level recommended in clinical practice guidelines ... ...

    Abstract Although many nephrologists see value in maximizing clearance and time on dialysis, clinical trials have failed to show a clear and consistent benefit of increasing clearance above the minimum threshold level recommended in clinical practice guidelines or of increasing dialysis session length or frequency. Available evidence suggests that patients and clinicians do not necessarily agree on what matters most when it comes to dialysis care, and that what patients consider to be an adequate dialysis session is highly individual and has little to do with solute clearance. Qualitative studies suggest that patients value spending less time on dialysis, having the dialysis procedure go smoothly, and being treated like an individual by staff members. Because many patients feel that they have little choice but to show up for their dialysis sessions, failing to involve them in decisions about time spent on the machine can contribute to feelings of powerlessness and loss of control, erode their sense of self, and diminish the quality of therapeutic relationships. On the other hand, a flexible and shared approach to decision-making about time spent on dialysis (and other aspects of care) can help to strengthen relationships, uphold personhood, and align care with what matters most.
    MeSH term(s) Humans ; Nephrologists ; Peritoneal Dialysis ; Renal Dialysis
    Language English
    Publishing date 2020-11-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1028193-9
    ISSN 1525-139X ; 0894-0959
    ISSN (online) 1525-139X
    ISSN 0894-0959
    DOI 10.1111/sdi.12938
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    Zs.A 2879: Show issues Location:
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  4. Article ; Online: Patient-Centered Care in Renal Medicine: Five Strategies to Meet the Challenge.

    O'Hare, Ann M

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2018  Volume 71, Issue 5, Page(s) 732–736

    Abstract: There is growing interest in patient-centered care, defined by the Institute of Medicine as "care that is respectful of and responsive to individual patient preferences, needs, and values." Although generally accepted as uncontroversial, the notion of " ... ...

    Abstract There is growing interest in patient-centered care, defined by the Institute of Medicine as "care that is respectful of and responsive to individual patient preferences, needs, and values." Although generally accepted as uncontroversial, the notion of "centering" care on our patients is in fact quite revolutionary. Because medical teaching, research, and practice have traditionally been organized around diseases and organ systems rather than patients, making care more patient centered would require no less than a paradigm shift in how we practice medicine. This would call for a frameshift in how we envision our role as health care providers and fundamental changes to the health care delivery systems in which we practice. Although individual providers may have limited power to change health systems (at least in the short term), there are some simple strategies within our reach that can help make our care more patient centered. These include a willingness to listen, make time, go beyond our job description, re-imagine what it means to provide "good" care, and see value in relationship building. Although putting these practices to work in the complex, specialized, and fragmented health systems in which many of us operate may be challenging, I would argue that this is a "beautiful challenge" with potentially far-reaching benefits for both patients and providers.
    MeSH term(s) Delivery of Health Care/organization & administration ; Female ; Health Personnel/economics ; Health Policy ; Humans ; Kidney Failure, Chronic/diagnosis ; Kidney Failure, Chronic/therapy ; Male ; Organizational Innovation ; Outcome Assessment (Health Care) ; Patient-Centered Care/organization & administration ; Policy Making ; Renal Dialysis/methods ; United States
    Language English
    Publishing date 2018-02-09
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S. ; Review
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2017.11.022
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    Zs.A 1669: Show issues Location:
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    Zs.MO 468: Show issues

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  5. Article ; Online: Concurrent Hospice and Dialysis: Proof of Concept.

    Butler, Catherine R / Wachterman, Melissa W / O'Hare, Ann M

    Journal of the American Society of Nephrology : JASN

    2022  Volume 33, Issue 10, Page(s) 1808–1810

    MeSH term(s) Humans ; United States ; Hospices ; Renal Dialysis ; Hospice Care ; Terminal Care
    Language English
    Publishing date 2022-09-12
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2022080919
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    Zs.A 3344: Show issues Location:
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  6. Article ; Online: Supporting scholarship in palliative care across the medical specialties.

    Butler, Catherine R / O'Hare, Ann M / Wong, Susan P Y

    Journal of pain and symptom management

    2022  Volume 63, Issue 6, Page(s) e665–e666

    MeSH term(s) Career Choice ; Fellowships and Scholarships ; Hospice and Palliative Care Nursing ; Humans ; Medicine ; Palliative Care
    Language English
    Publishing date 2022-05-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639142-4
    ISSN 1873-6513 ; 0885-3924
    ISSN (online) 1873-6513
    ISSN 0885-3924
    DOI 10.1016/j.jpainsymman.2022.02.007
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    Zs.A 2252: Show issues Location:
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  7. Article ; Online: Embracing Complexity: How to Build an Evidence Base Capable of Supporting Patient-Centered Care.

    O'Hare, Ann M

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2017  Volume 70, Issue 4, Page(s) 453–455

    MeSH term(s) Humans ; Patient-Centered Care ; Renal Dialysis ; Surveys and Questionnaires
    Language English
    Publishing date 2017-09-21
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2017.06.019
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    Zs.A 1669: Show issues Location:
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  8. Article ; Online: Experiences of US Clinicians Contending With Health Care Resource Scarcity During the COVID-19 Pandemic, December 2020 to December 2021.

    Butler, Catherine R / Wightman, Aaron G / Taylor, Janelle S / Hick, John L / O'Hare, Ann M

    JAMA network open

    2023  Volume 6, Issue 6, Page(s) e2318810

    Abstract: Importance: The second year of the COVID-19 pandemic saw periods of dire health care resource limitations in the US, sometimes prompting official declarations of crisis, but little is known about how these conditions were experienced by frontline ... ...

    Abstract Importance: The second year of the COVID-19 pandemic saw periods of dire health care resource limitations in the US, sometimes prompting official declarations of crisis, but little is known about how these conditions were experienced by frontline clinicians.
    Objective: To describe the experiences of US clinicians practicing under conditions of extreme resource limitation during the second year of the pandemic.
    Design, setting, and participants: This qualitative inductive thematic analysis was based on interviews with physicians and nurses providing direct patient care at US health care institutions during the COVID-19 pandemic. Interviews were conducted between December 28, 2020, and December 9, 2021.
    Exposure: Crisis conditions as reflected by official state declarations and/or media reports.
    Main outcomes and measures: Clinicians' experiences as obtained through interviews.
    Results: Interviews with 23 clinicians (21 physicians and 2 nurses) who were practicing in California, Idaho, Minnesota, or Texas were included. Of the 23 total participants, 21 responded to a background survey to assess participant demographics; among these individuals, the mean (SD) age was 49 (7.3) years, 12 (57.1%) were men, and 18 (85.7%) self-identified as White. Three themes emerged in qualitative analysis. The first theme describes isolation. Clinicians had a limited view on what was happening outside their immediate practice setting and perceived a disconnect between official messaging about crisis conditions and their own experience. In the absence of overarching system-level support, responsibility for making challenging decisions about how to adapt practices and allocate resources often fell to frontline clinicians. The second theme describes in-the-moment decision-making. Formal crisis declarations did little to guide how resources were allocated in clinical practice. Clinicians adapted practice by drawing on their clinical judgment but described feeling ill equipped to handle some of the operationally and ethically complex situations that fell to them. The third theme describes waning motivation. As the pandemic persisted, the strong sense of mission, duty, and purpose that had fueled extraordinary efforts earlier in the pandemic was eroded by unsatisfying clinical roles, misalignment between clinicians' own values and institutional goals, more distant relationships with patients, and moral distress.
    Conclusions and relevance: The findings of this qualitative study suggest that institutional plans to protect frontline clinicians from the responsibility for allocating scarce resources may be unworkable, especially in a state of chronic crisis. Efforts are needed to directly integrate frontline clinicians into institutional emergency responses and support them in ways that reflect the complex and dynamic realities of health care resource limitation.
    MeSH term(s) Male ; Humans ; Middle Aged ; Female ; COVID-19/epidemiology ; Pandemics ; Physicians ; Health Resources ; Delivery of Health Care
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.18810
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  9. Article ; Online: Supporting the Employment Goals of People With Kidney Disease.

    O'Hare, Ann M / Rodriguez, Rudolph A / van Eijk, Marieke

    American journal of kidney diseases : the official journal of the National Kidney Foundation

    2021  Volume 78, Issue 6, Page(s) 772–773

    MeSH term(s) Employment ; Goals ; Humans ; Kidney Diseases/epidemiology ; Kidney Diseases/therapy
    Language English
    Publishing date 2021-07-24
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 604539-x
    ISSN 1523-6838 ; 0272-6386
    ISSN (online) 1523-6838
    ISSN 0272-6386
    DOI 10.1053/j.ajkd.2021.05.010
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  10. Article ; Online: Do-Not-Resuscitate Orders among Patients with ESKD Admitted to the Intensive Care Unit: A Bird's Eye View.

    Scherer, Jennifer S / O'Hare, Ann M

    Journal of the American Society of Nephrology : JASN

    2020  Volume 31, Issue 10, Page(s) 2232–2234

    MeSH term(s) Critical Illness ; Hospitalization ; Humans ; Intensive Care Units ; Resuscitation Orders
    Language English
    Publishing date 2020-08-27
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, U.S. Gov't, P.H.S. ; Comment
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2020081160
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