Abstract Introduction The Three Wishes Project (3WP) was developed to humanize the dying process by honoring simple, meaningful wishes for patients and their families. Although the program has been shown to be both feasible and cost effective in tertiary care hospitals, its implementation in resource-limited safety-net hospitals serving lower income and racially diverse populations is not well described. In 2024, we launched the 3WP in the mixed medical and surgical ICU of Montefiore Wakefield, a safety-net teaching ICU, to explore the feasibility and impact of the 3WP in an underserved population. Methods The 3WP was implemented by multidisciplinary staff, including nurses and physicians following training to identify patients approaching the end of life and to work with families to elicit personalized wishes. Wishes were documented using a standardized Epic dot phrase and fulfilled by ICU staff. A natural language processing tool was used to identify three wishes’ notes and periodically evaluate the frequency of the intervention and then provide feedback to front line stakeholders to encourage improved participation. Data was retrospectively analyzed over the first 12 months of the project initiation to determine quantitative and qualitative aspects of the 12-month experience. Results The 3WP was completed for 66 patients, fulfilling 174 wishes over the course of 12 months. The 3WP was most often documented as initiated by family members (77 cases, 44%), by nurses (70 cases, 40%) and then physicians in (27 cases, 16%). Wishes were most commonly implemented by nurses (140 cases, 80%) followed by physicians (30 cases, 17%). Most wishes (159, 91%) were implemented pre-mortem. The most common wishes fulfilled were EKG keepsakes (28%) and the playing of music (22%). Other common wishes included fingerprint keepsakes, giving of flowers, pastoral care and aroma therapy. Narrative feedback from staff recorded in the medical record the positive qualitative experiences of providing the 3WP to patients and families. Conclusion Implementation of the 3WP into a safety net hospital ICU serving a resource-limited population was feasible and humanizing to patients, families and providers. Our experience demonstrated that individualized compassionate care could occur effectively, in under-resourced settings. The nursing team was instrumental to the effort to implement this initiative. As we expand the 3WP in our safety net institution, we aim to evaluate if this model can function and be impactful outside the ICU. This abstract is funded by: None
Ng et al. (Fri,) studied this question.