End of Life

Clinical Pathways promote evidence-based, safe, and high-value patient care by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by a methodical review of available evidence and consensus among committee members.

Clinical Pathway:

• End-of-Life Algorithm
• End-of-Life Synopsis (provides care standards employed for this clinical pathway)

Inclusion and exclusion criteria:

• Inclusion:
  • When currently admitted to an inpatient unit and:
    • Parent, caregiver, or patient chooses to pursue comfort-focused end-of-life care
    • Patient’s clinical status has changed to a life expectancy of a few hours to a few days
  • Exclusion:
    • Patient in PICU, CICU, or ICN
    • Any patient with an active police investigation

Committee members involved in the development:

• John Stroh, MD, FAAP | Palliative Care | Committee Co-Chair
• Amy Johnson, MD, MBA | Hematology/Oncology/BMT Fellow| Committee Co-Chair
• Jenni Linebarger, MD, MPH, FAAP, FAAHPM | Palliative Care | Committee Member
• Julia Hays, MD | Hematology/Oncology/BMT | Committee Member
• Chris Klockau, RPh, BCOP | Pharmacy | Committee Member
• Ashley Daly, MD | Hospital Medicine | Committee Member
• Becky Crouse, DMin, MDiv, BCC | Spiritual Services | Committee Member
• Corey Pagnotta, DO | Resident | Committee Member
• Aly Schmidt, MSN, RN, CPN, CHPPN | Palliative Care | Committee Member

Patient/Family Committee Member:

• Jana Rajas, MPT | Patient Family Engagement |Committee Member

EBP Committee Members:

• Kathleen Berg, MD, FAAP | Evidence Based Practice
• Andrea Melanson, OTD, OTR/L | Evidence Based Practice 

Publication dates:

• Finalized date: 05/2024
• Next expected revision date: May 2027

Concerns with content:

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu. 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.