TY - JOUR
T1 - Arranging Hospice Care from the Emergency Department
T2 - A Single Center Retrospective Study
AU - Rege, Rahul M.
AU - Peyton, Kelee
AU - Pajka, Sarah E.
AU - Grudzen, Corita R.
AU - Conroy, Mark J.
AU - Southerland, Lauren T.
N1 - Publisher Copyright:
© 2022
PY - 2022/3
Y1 - 2022/3
N2 - Background: Arranging hospice services from the Emergency Department (ED) can be difficult due to physician discomfort, time constraints, and the intensity of care coordination needed. We report patient and visit characteristics associated with successful transition from the ED directly to hospice. Methods: Setting: Academic ED with 82,000 annual visits. Population: ED patients with a referral to hospice order placed during the ED visit from January 2014-December 2018. Charts were abstracted by trained, non-blinded personnel. Primary goal was to evaluate patient and visit factors associated with requiring admission for hospice transition. Results: Electronic Health Record inquiry yielded 113 patients, 93 of which met inclusion criteria. Patients were aged 65.8 years (range 32-92), 54% were female, and 78% were white, non-hispanic. The majority had cancer (78%, n = d72) and were on public insurance (60%, n = 56). Half (55%, n = 51) were full code upon arrival. Average ED length of stay was 4.6 ± 2.6 hours. Discharge from the ED to hospice was successful for 38% (n = 35), a few (n = 5) were dispositioned to an ED observation unit, and 57% (n = 53) were admitted. Only 10 (11%) required an inpatient length of stay longer than an observation visit (2 days). Case management and social work team arranged for transportation (54.8%, n = 51), hospital beds (16.1%, n = 16), respiratory equipment (18.3%, n = 17), facility placement (33.3%, n = 31), and home health aides (29.0%, n = 27). Conclusion: Transitioning patients to hospice care from the ED is possible within a typical ED length of stay with assistance from a case manager/social work team.
AB - Background: Arranging hospice services from the Emergency Department (ED) can be difficult due to physician discomfort, time constraints, and the intensity of care coordination needed. We report patient and visit characteristics associated with successful transition from the ED directly to hospice. Methods: Setting: Academic ED with 82,000 annual visits. Population: ED patients with a referral to hospice order placed during the ED visit from January 2014-December 2018. Charts were abstracted by trained, non-blinded personnel. Primary goal was to evaluate patient and visit factors associated with requiring admission for hospice transition. Results: Electronic Health Record inquiry yielded 113 patients, 93 of which met inclusion criteria. Patients were aged 65.8 years (range 32-92), 54% were female, and 78% were white, non-hispanic. The majority had cancer (78%, n = d72) and were on public insurance (60%, n = 56). Half (55%, n = 51) were full code upon arrival. Average ED length of stay was 4.6 ± 2.6 hours. Discharge from the ED to hospice was successful for 38% (n = 35), a few (n = 5) were dispositioned to an ED observation unit, and 57% (n = 53) were admitted. Only 10 (11%) required an inpatient length of stay longer than an observation visit (2 days). Case management and social work team arranged for transportation (54.8%, n = 51), hospital beds (16.1%, n = 16), respiratory equipment (18.3%, n = 17), facility placement (33.3%, n = 31), and home health aides (29.0%, n = 27). Conclusion: Transitioning patients to hospice care from the ED is possible within a typical ED length of stay with assistance from a case manager/social work team.
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U2 - 10.1016/j.jpainsymman.2021.08.002
DO - 10.1016/j.jpainsymman.2021.08.002
M3 - Article
C2 - 34411660
AN - SCOPUS:85123720589
SN - 0885-3924
VL - 63
SP - e281-e286
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 3
ER -
