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- ED Manag. 2014 Mar 1; 26 (3): 27-30.
AbstractA new study suggests that introducing palliative care consultations while patients are still in the ED, rather than waiting until after patients have been admitted, can significantly reduce inpatient length of stay. Experts say the approach may also improve quality of care while patients are in the hospital, and do a better job of meeting patient goals. *Researchers analyzed 1,435 palliative care consults, including 50 that took place in the ED over a four-year period. They found that consultation in the ED was associated with hospital stays that were 3.6 days shorter, on average, than the hospital stays of patients who received palliative care consults following admission to the hospital. * Palliative care typically includes an extensive goals-of-care discussion with patients and families, symptom management, and other services focused on meeting patient needs and improving quality of life. * Experts say the top four groups of patients who can benefit from goals-of-care discussions are patients with metastatic cancer, advanced congestive heart failure, advanced chronic obstructive pulmonary disease, and advanced dementia. *ED administrators interested in making improvements in their approach to palliative care should perform a needs assessment, forge partnerships with community resources, and identify a champion, according to palliative care experts.
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