Preliminary Analysis of a Modified Screening Tool to Increase the Frequency of Palliative Care Consults

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The American journal of hospice & palliative care


PURPOSE: Palliative care interventions have been shown to improve patient quality of life but the benefit may be less if interventions occur late in the patient's disease process. The objective of this study was to evaluate whether an objective screening tool could improve the frequency and timeliness of palliative care consultation.

METHODS: Using a quasi-experimental design with 2 geographically separate medical intensive care units (MICUs), the control MICU continued existing consultation practice and the intervention MICU implemented a screening tool with each new admission. Any item checked on the screening tool triggered a palliative care consult within 24 hours of admission to the MICU.

RESULTS: A total of 223 MICU admissions were evaluated: 156 patients in the control group and 67 patients in the intervention group. More consults were generated in the intervention group (22.39%) compared to the control group (7.05%; P < .001). The median time to consultation was lower in the intervention group compared to the control group (1 day vs 2 days; P < .01).

CONCLUSION: Implementing a simple, objective screening tool increased palliative consultation rates and decreased median time to palliative consultation in our institution's MICU.

Medical Subject Headings

Adult; Aged; Female; Humans; Intensive Care Units; Male; Mass Screening; Middle Aged; Palliative Care; Prospective Studies; Quality of Life; Referral and Consultation; Time Factors

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