Feasibility of a Two-Step Palliative Screening Utilizing Existing Emergency Department Resources

Area of Science:

• Emergency Medicine
• Palliative Care
• Healthcare Management

Background:

• The Emergency Department (ED) is an ideal setting for early palliative care.
• Staffing limitations often prevent ED-palliative care partnerships.

Purpose of the Study:

• To assess the feasibility of a two-step protocol for integrating palliative care into the ED.
• To determine if the protocol could increase palliative care consultations without additional staffing.

Main Methods:

• A two-step screening protocol was implemented.
• A clinical decision support tool identified patients with treatment/code status limitations.
• Care coordinators screened patients and initiated palliative care consultations for those with unmet needs.

Main Results:

• Palliative care consultations from the ED increased by 110% (32 to 67).
• 57% of patients screening positive for unmet palliative needs received a consultation.
• The protocol was feasible without requiring additional staff.

Conclusions:

• A two-step ED-palliative protocol is feasible.
• The protocol effectively increased palliative care consultations from the ED.
• Early palliative care integration in the ED is achievable with existing resources.