Authors

  1. Smith, Catherine V. DNP, RN, CCNS, CCRN
  2. Maduro, Ralitsa S. PhD
  3. Morgan, Merri K. DNP, RN, CCRN
  4. Ver Schneider, Patricia
  5. Rutledge, Carolyn M. PhD, FNP-BC
  6. Zimbro, Kathie S. PhD, RN

Abstract

Background: Despite growth in service availability, palliative care (PC) referrals are often underutilized or delayed, which may compromise patient outcomes.

 

Local Problem: Underutilized or delayed PC referrals among hospitalized adults prompted this project aimed at improving PC measures, quality, and utilization outcomes.

 

Methods: Data extracted from the electronic medical record were used to identify needed improvements in PC.

 

Intervention: Interdisciplinary rounds (IDRs) were implemented on the hospitalist service in a nonintensive care setting.

 

Results: Following implementation, median time to PC referral decreased by 2 days. Length of stay (LOS), direct cost, and 30-day mortality also decreased. Postintervention patients were more likely to transition home compared with another facility.

 

Conclusions: Results support IDRs as a mechanism to improve time to PC referral, decrease LOS, direct cost, and 30-day mortality among hospitalized adults. A more objective method of identifying patients with unmet PC needs may be warranted.