Background The 3 Wishes Project (3WP) is an end-of-life program that aims to honor the dignity of dying patients by creating meaningful patient- and family-centered memories while promoting humanistic interprofessional care. Objective To determine whether this palliative intervention could be successfully implemented-defined as demonstrating value, transferability, affordability, and sustainability-beyond the intensive care unit in which it was created. Design Mixed-methods formative program evaluation. (ClinicalTrials.gov: NCT04147169). Setting 4 North American intensive care units. Participants Dying patients, their families, clinicians, hospital managers, and administrators. Intervention Wishes from dying patients, family members, and clinicians were elicited and implemented. Measurements Patient characteristics and processes of care; the number, type, and cost of each wish; and semistructured interviews and focus groups with family members, clinicians, and managers. Results A total of 730 patients were enrolled, and 3407 wishes were elicited. Qualitative data were gathered from 75 family members, 72 clinicians, and 20 managers or hospital administrators. Value included intentional comforting of families as they honored the lives and legacies of their loved ones while inspiring compassionate clinical care. Factors promoting transferability included family appreciation and a collaborative intensive care unit culture committed to dignity-conserving end-of-life care. Staff participation evolved from passive support to professional agency. Program initiation required minimal investment for reusable materials; thereafter, the mean cost was $5.19 (SD, $17.14) per wish. Sustainability was demonstrated by the continuation of 3WP at each site after study completion. Limitation This descriptive formative evaluation describes tertiary care center-specific experiences rather than aiming for generalizability to all jurisdictions. Conclusion The 3WP is a transferrable, affordable, and sustainable program that provides value to dying patients, their families, clinicians, and institutions. Primary Funding Source Greenwall Foundation.

中文翻译：

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富有同情心的临终护理：3个愿望项目的混合方法多站点评估。

背景“ 3个愿望”项目（3WP）是一个生命终结项目，旨在通过创造有意义的以患者和家庭为中心的记忆，同时促进人文专业服务，尊重垂死患者的尊严。目的确定这种姑息性干预措施是否可以成功实施，定义为在重症监护病房所在的地方证明其价值，可转让性，可负担性和可持续性。设计混合方法形成程序评估。（ClinicalTrials.gov：NCT04147169）。设置4个北美重症监护室。参与者垂死的患者，他们的家人，临床医生，医院管理人员和管理人员。提出并实施了垂死患者，家庭成员和临床医生的干预愿望。测量患者特征和护理过程；每个愿望的数量，类型和成本；以及与家庭成员，临床医生和管理人员的半结构式访谈和焦点小组。结果共招募了730例患者，并提出了3407个愿望。定性数据来自75位家庭成员，72位临床医生以及20位经理或医院管理员。价值包括在鼓励同情的临床护理的同时尊重家人的生活和遗产，有意安慰家人。促进可转移性的因素包括家庭赞赏和致力于维护尊严的临终关怀的协作重症监护病房文化。员工的参与从被动支持演变为专业代理。启动计划需要对可重复使用的材料进行最少的投资；此后，每个愿望的平均成本为5.19美元（标准差，17.14美元）。研究完成后，每个站点的3WP持续运行证明了可持续性。局限性这种描述性的形成性评估描述了三级医疗中心的特定经历，而不是旨在普及到所有辖区。结论3WP是一种可转让，可负担且可持续的计划，可为垂死的患者，他们的家人，临床医生和机构提供价值。主要资金来源Greenwall基金会。和机构。主要资金来源Greenwall基金会。和机构。主要资金来源Greenwall基金会。