3 Wishes Without Borders: Enhancing End of Life Care for Hospitalized Patients

Background The 3 Wishes Project (3WP) was developed at St. Joseph’s Healthcare Hamilton to humanize the dying process by engaging patients and families in last wishes. Our objective was to pilot the 3WP on medical wards to gauge interest in expanding outside the intensive care unit (ICU) where it began. Methods We enrolled medical patients who had a high probability of dying during their admission, eliciting, implementing, and documenting terminal wishes. We analyzed data descriptively. Results From January 2017 to March 2020, we enrolled 23 patients and elicited 117 wishes (mean five wishes/patient). Direct engagement in the wish process was possible for 57% of patients. Common wish categories were: facilitating connections, family care, and humanizing the environment. The mean cost/patient was $16; 85% of wishes incurred no cost to the program. Conclusions The initial patients garnered sufficient interest to warrant further expansion. The 3WP was affordable and characterized by increased patient engagement.