Implementation of a Standardized Screening Process to Increase Palliative Care Referrals in Primary Care: An...

Area of Science:

• Palliative Care
• Quality Improvement
• Primary Care Medicine

Background:

• Palliative care referrals in primary care often rely on subjective provider judgment, leading to underutilization and access disparities.
• Existing awareness initiatives have not fully addressed the systemic issues in primary care palliative care referrals.

Purpose of the Study:

• To develop and implement an evidence-based, standardized palliative care referral protocol.
• To increase the palliative care referral rate for eligible patients within a primary care setting.

Main Methods:

• A preimplementation and postimplementation study design was employed.
• The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework guided the project.
• A standardized referral protocol was developed and implemented over a 10-month period.

Main Results:

• The palliative care referral rate increased from 2% to 11% postimplementation, a 9% rise.
• Patients receiving palliative care referrals experienced a 69% decrease in emergency room visits.
• Hospitalizations decreased by 73% for patients referred to palliative care.

Conclusions:

• A standardized referral protocol is effective in increasing palliative care access in primary care.
• The protocol demonstrates potential for improving patient outcomes by reducing acute care utilization.
• Expansion of this protocol to other primary care clinics is recommended to enhance quality patient care.