• J Pain Symptom Manage · May 2024

    Feasibility of a Two-Step Palliative Screening Utilizing Existing Emergency Department Resources.

    • Razeen Karim, Mustapha Saheed, Jamison Kies, Michelle Churchill, Balakrishna Vemula, and Danielle J Doberman.
    • Department of Medicine (R.K., J.K., M.C., B.V., D.D.), Section of Palliative Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Electronic address: rkarim2@jh.edu.
    • J Pain Symptom Manage. 2024 May 1; 67 (5): e417e424e417-e424.

    BackgroundAlthough the Emergency Department (ED) offers a unique setting to provide early palliative care, staffing limitations curtail hospitals from establishing ED-palliative partnerships.MeasuresFeasibility of a two-step ED-palliative screening protocol was defined by two criteria: a ≥ 50% increase in palliative consults originating from the ED and a ≥ 50% consultation completion rate for patients who screened positive for unmet palliative needs.InterventionA clinical decision support tool identified patients with treatment/code status limitations and prompted a care coordination referral. Care coordinators screened patients for unmet palliative needs using a content-validated screening tool and consulted palliative care for positive screens.OutcomePalliative care consultations originating from the ED increased by 110% from 32 to 67 consultations, and 57% (40/70) of patients who screened positive for unmet palliative needs received a consultation.Conclusions/Lessons LearnedOur project demonstrated feasibility of a two-step ED-palliative protocol by increasing palliative care consultation without necessitating additional staff.Published by Elsevier Inc.

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