Personalized Patient and Family Experience at EOL
The 3WP was perceived by clinicians and key stakeholders to improve the
patient experience by personalizing EOL care, prompting important
conversations, and returning some decision-making to the patient and
family. Nurses and the physician indicated that the 3WP helped to
individualize care in the patient’s final moments. A physician shared
one of the wishes where a nurse, “… got the frame and some ink
and she made a thumbprint heart with the grandma’s thumb and the
grandchild’s thumb. I just thought that was so beautiful, and it’s easy
to do, it’s personalized.” [P4 ] Others discussed that by
eliciting wishes, they were encouraged to engage in conversations to
better understand what is important to the patient. A bedside nurse
commented that the 3WP, “sparks a conversation, which I think we should
all have in those moments, or even before EOL… what is important
to us and what is important in our care.”[P1 ] Another
nurse observed that, “it gives decision making back to the family and
the patient.” [P1 ] A clinician emphasized how the 3WP
“gives [the family] permission to ask for [something] or gives
them permission to say “Yeah, I would love that,” or “He would love
that.” [P2 ] Eliciting wishes from families was perceived
to give families a voice and seemed to help address common feelings of
overwhelming helplessness through acknowledging these wishes.