• Rahul M Rege, Kelee Peyton, Sarah E Pajka, Corita R Grudzen, Mark J Conroy, and Lauren T Southerland.
• Department of Emergency Medicine, The Ohio State University, (R.M.R., K.P., M.J.C., L.T.S.) Columbus OH. Electronic address: Rrege6@gmail.com.
• J Pain Symptom Manage. 2022 Mar 1; 63 (3): e281e286e281-e286.

BackgroundArranging hospice services from the Emergency Department (ED) can be difficult due to physician discomfort, time constraints, and the intensity of care coordination needed. We report patient and visit characteristics associated with successful transition from the ED directly to hospice.MethodsSetting: Academic ED with 82,000 annual visits.PopulationED patients with a referral to hospice order placed during the ED visit from January 2014-December 2018. Charts were abstracted by trained, non-blinded personnel. Primary goal was to evaluate patient and visit factors associated with requiring admission for hospice transition.ResultsElectronic Health Record inquiry yielded 113 patients, 93 of which met inclusion criteria. Patients were aged 65.8 years (range 32-92), 54% were female, and 78% were white, non-hispanic. The majority had cancer (78%, n = d72) and were on public insurance (60%, n = 56). Half (55%, n = 51) were full code upon arrival. Average ED length of stay was 4.6 ± 2.6 hours. Discharge from the ED to hospice was successful for 38% (n = 35), a few (n = 5) were dispositioned to an ED observation unit, and 57% (n = 53) were admitted. Only 10 (11%) required an inpatient length of stay longer than an observation visit (2 days). Case management and social work team arranged for transportation (54.8%, n = 51), hospital beds (16.1%, n = 16), respiratory equipment (18.3%, n = 17), facility placement (33.3%, n = 31), and home health aides (29.0%, n = 27).ConclusionTransitioning patients to hospice care from the ED is possible within a typical ED length of stay with assistance from a case manager/social work team.Copyright © 2022. Published by Elsevier Inc.

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