Emergency Department Initiated Palliative Care Consultation in a Rural Setting
Allison M Tadros1,2, Harsha Sai Sreemantula2, Alexander H Tadros1
1Department of Emergency Medicine, West Virginia University, Morgantown, WV, USA.
The American Journal of Hospice & Palliative Care
|July 27, 2026
Summary
Palliative care (PC) consultations in the emergency department (ED) can improve patient outcomes in rural settings. Early ED PC consults led to shorter hospital stays and fewer intensive care unit (ICU) days.
Area of Science:
- Medical Science
- Healthcare Management
- Geriatrics
Background:
- Palliative care (PC) consults can influence patient care decisions earlier when initiated in the emergency department (ED) compared to inpatient settings.
- Previous research on ED PC consults primarily focused on urban healthcare environments.
- This study addresses the impact of ED PC consults in a rural healthcare setting.
Purpose of the Study:
- To compare the outcomes of palliative care consultations initiated in the emergency department versus those initiated after hospital admission.
- To evaluate the impact of early palliative care intervention on patient disposition, length of stay, and advance care planning in a rural healthcare setting.
Main Methods:
- A retrospective comparison of 150 patients who received ED PC consultation with 150 patients who received inpatient PC consultation.
- Data collected included patient disposition, hospital and intensive care unit (ICU) length of stay (LOS), advance care planning documentation, and code status changes.
- Analysis focused on comparing outcomes between the ED PC group and the inpatient PC group within a rural healthcare system.
Main Results:
- Patients receiving ED PC consults were less likely to be admitted to the ICU and had significantly shorter ICU and hospital LOS.
- Advance care planning documentation was higher in the ED PC group (94.7%) compared to the inpatient PC group (87.3%).
- Both groups demonstrated high rates of code status changes, indicating effective communication regarding patient wishes.
Conclusions:
- Palliative care consultation in the emergency department in rural settings is associated with improved patient outcomes, including reduced hospital and ICU LOS.
- Early initiation of palliative care in the ED facilitates advance care planning and potentially reduces ICU utilization.
- Integrating palliative care into the emergency department can optimize patient care and resource utilization in rural healthcare systems.
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