Brigham and Women streamlines ED-to-hospice transfers

Boston-based Brigham and Women's Hospital implemented a program to more quickly transfer older patients with terminal illnesses from emergency departments to hospice facilities.

Before implementing the program, researchers found that 22.6% of patients in need of it were moved into hospice care, on average, within 96 hours. But after implementation, 54.1% of patients were moved into hospice care within 96 hours, according to results published July 8 in JAMA Network Open.

Using an artificial intelligence algorithm in its electronic health record system, in combination with in-person evaluations, researchers were able to quickly identify hospice-eligible patients and coordinate efforts to get them into care in a more timely manner. 

While hospital length of stay was not really reduced after the initiatives' implementation, fewer patients died in the emergency department because more were transitioned into hospice care, which recognized their wishes, more quickly.

"Identifying hospice candidates quickly after ED arrival mostly falls on the shoulders of ED clinicians, so our goal with the program is to make this process as simple and efficient as possible," study author Christopher Baugh, MD, an emergency physician at Brigham and Women's Hospital, said in the release. "With our approach, we're able to mobilize the hospice transition within one to two days most times, which is much faster than would be possible if the patient was admitted directly into inpatient care."

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