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Related Concept Videos

Continuing Care01:25

Continuing Care

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Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
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Planning Nursing Care I01:21

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The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
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Methods of Documentation VI: Case Management Model01:15

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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Discharge Summary Forms01:31

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The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
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Heart Failure V: Medical Management01:30

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Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
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Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
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Related Experiment Video

Updated: Dec 9, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
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Emergency Department Admission Triggers for Palliative Consultation May Decrease Length of Stay and Costs.

David H Wang1, Ryan Heidt1

  • 1Division of Palliative Medicine, Scripps Health, San Diego, California, USA.

Journal of Palliative Medicine
|September 8, 2020
PubMed
Summary

Simplified emergency department (ED) palliative consultations significantly reduce hospital length of stay and costs. Early palliative care engagement via ED triggers improves patient outcomes and resource utilization.

Keywords:
early palliative careemergency department palliativeemergency medicine palliativepalliative costpalliative financialpalliative length of stay

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Area of Science:

  • Palliative Care
  • Health Services Research
  • Health Economics

Background:

  • Emergency department (ED) initiated palliative consultations can influence downstream care.
  • Existing palliative care admission triggers lack standardized best practices and outcome data.
  • The optimal timing and method for initiating palliative consultations require further investigation.

Purpose of the Study:

  • To evaluate the clinical, operational, and financial impact of simplified ED-initiated palliative consultations.
  • To compare ED-initiated palliative consults against traditional Floor and Intensive Care Unit (ICU) consultations.
  • To assess the effectiveness of a three-criterion trigger system for bedside actionability and sustainability.

Main Methods:

  • An 18-month single-center study comparing ED-initiated palliative consults with Floor and ICU consults.
  • Simplified ED admission triggers: end-stage illness, functional limitation, and clinician surprise criteria.
  • Matched cohort analysis to evaluate financial outcomes and length of stay (LOS) differences.

Main Results:

  • The proportion of ED-initiated palliative consults significantly increased from 7% to 19%.
  • ED-initiated consults showed similar ED LOS and inpatient mortality compared to Floor consults.
  • ED consults were associated with significantly shorter median LOS before consult (0 vs. 3 days) and overall hospital LOS (1-3.5 days shorter).

Conclusions:

  • Simple ED admission triggers expedite palliative engagement, leading to substantial reductions in hospital LOS and costs.
  • ED-initiated palliative consultations are associated with a 50-75% reduction in hospital LOS and costs compared to usual practice.
  • Expedited palliative care through ED initiation improves efficiency and potentially patient outcomes by reducing lead time to consultation.