Interdisciplinary Rounds on a Hospitalist Service: Impact on Palliative Care Measures, Quality, and Utilization...

Area of Science:

• Healthcare Management
• Clinical Practice Improvement
• Patient Outcomes Research

Background:

• Palliative care (PC) services are increasingly available but often underutilized or delayed.
• Delayed or missed PC referrals can negatively impact patient outcomes.
• Hospitalized adult patients frequently experience suboptimal timing of PC referrals.

Purpose of the Study:

• To improve palliative care (PC) measures, quality, and utilization outcomes.
• To address the problem of underutilized or delayed PC referrals in hospitalized adults.
• To evaluate the impact of interdisciplinary rounds on PC referral timeliness and patient outcomes.

Main Methods:

• Utilized electronic medical record data to identify areas for PC improvement.
• Implemented interdisciplinary rounds (IDRs) on a hospitalist service in a non-intensive care setting.
• Analyzed changes in PC referral timing, length of stay, cost, mortality, and discharge disposition post-intervention.

Main Results:

• Median time to palliative care (PC) referral decreased by 2 days after IDR implementation.
• Significant reductions observed in length of stay (LOS), direct costs, and 30-day mortality.
• Patients receiving care post-intervention were more likely to transition home compared to other facilities.

Conclusions:

• Interdisciplinary rounds (IDRs) are an effective mechanism for improving timely palliative care (PC) referrals.
• IDRs contribute to reduced length of stay, direct costs, and 30-day mortality in hospitalized adults.
• Further research into objective methods for identifying patients with unmet PC needs is warranted.