Inpatient Palliative Care Consultations From a Canadian Clinical Teaching Unit: Who is Referred and When?

Area of Science:

• Palliative Care Medicine
• Internal Medicine
• Health Services Research

Background:

• Inpatient palliative care consultations enhance quality of life and reduce healthcare utilization for patients with life-limiting illnesses.
• Clinical Teaching Units (CTUs) frequently admit patients with advanced cancer and end-stage organ failure.
• The utilization of palliative care consultations within CTUs has not been previously studied.

Purpose of the Study:

• To characterize patients referred from CTUs to inpatient palliative care.
• To identify opportunities for quality improvement in palliative care integration.
• To examine referral patterns for both malignant and non-malignant diseases.

Main Methods:

• A descriptive study was conducted over a 1-year period (August 2013 - July 2014).
• Data were collected on all patients referred from LHSC CTUs to inpatient palliative care.
• Referral timing and patient diagnoses were analyzed.

Main Results:

• 638 patients were referred from CTUs to palliative care over the study period.
• 55% of referred patients died during their hospital admission.
• Patients with non-cancer diagnoses were referred significantly later than those with cancer diagnoses.

Conclusions:

• Palliative care consultations are utilized for a diverse range of conditions, indicating awareness of their benefits.
• Earlier palliative care integration is crucial, especially for non-cancer diagnoses.
• Modeling early palliative care in CTUs is essential for improving end-of-life care during medical training.