A pilot program at Grand Rapids, Mich.-based Corewell Health reduced inpatient mortality, readmission, ICU utilization and the total cost of care, while boosting staff satisfaction, Hospice News reported Oct. 28.
The change?
Embedding a palliative care practitioner into the emergency department.
"The emergency department is the entryway to the health care system for virtually all patients," said Johnathan Abraham, MD, a palliative medicine and emergency medicine physician who joined Corewell as part of the pilot program.
Dr. Abraham's remarks were made at the National Hospice and Palliative Care Organization Annual Leadership Conference in Denver. "It is a place where critical decisions are made that can totally alter the trajectory of care plans that impact patients and providers in myriad ways," he continued. "All comers to the emergency department, three quarters of them, are presenting with pain or other bothersome symptoms. It’s also an environment that predominantly serves vulnerable populations and underrepresented minorities," he said.
The pilot program not only added a palliative care professional to the team Monday through Friday, but educated other ED staff on hospice and palliative care. It developed associated workflows for hospice patients who come to the ED, seriously ill patients with multiple comorbidities, and patients who experience a catastrophic event and are likely to die within a few days.
One study found systems can see a 6.7-times return on investment by embedding a palliative care clinician in the ED. These healthcare workers can also increase hospice and palliative care clinic referrals.
Another study found that a palliative practitioner increased consults by 591% in one year and resulted in a more than 50% reduction in median hospital length of stay.