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Implementing a Standardized Workflow Process to Increase the Palliative Care to Hospice Admission Rate
Charissa Boyd1, Mary C DiBartolo, D'Jenie Helne
1Capital Caring Health, Largo, Maryland (Dr Boyd); Salisbury University School of Nursing, Salisbury, Maryland (Dr DiBartolo); Capital Caring Health, Falls Church, Virginia (Dr Helne); and Hospice of Acadiana, Inc, Lafayette, Louisiana (Mr Everett).
Journal of Nursing Care Quality
|December 3, 2022
Summary
Standardizing workflows for palliative care patients transitioning to hospice services improved admission rates by 11.5%. This quality improvement initiative streamlined the process, increasing hospice admissions and enhancing patient care transitions.
Area of Science:
- Healthcare Quality Improvement
- Palliative and Hospice Care
- Process Standardization
Background:
- Palliative care is a vital precursor to hospice care, offering symptom relief and improving quality of life.
- Hospice care, an underutilized Medicare benefit, can decrease healthcare costs.
- Delays in the admission process were identified as a barrier for palliative patients transitioning to hospice.
Purpose of the Study:
- To evaluate the impact of standardizing workflow processes on hospice admission rates.
- To determine if improved chart completion enhances the transition from palliative to hospice care.
Main Methods:
- A quality improvement project utilizing Kurt Lewin's change theory and Plan-Do-Study-Act (PDSA) cycles.
- Data collection occurred preintervention (May-August 2021) and postintervention (September-December 2021).
- Workflow standardization involved assigning urgency levels to referrals and deactivating electronic medical record (EMR) charts upon completion.
Main Results:
- The palliative care to hospice admission rate increased by 11.5% postintervention.
- Electronic medical record (EMR) chart deactivation rate saw a statistically significant increase of 55.3% (P ≤ .001).
Conclusions:
- Standardized workflows effectively increased hospice admissions for palliative care patients.
- The intervention improved the efficiency and effectiveness of care transitions to hospice services.
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