Palliative care, end-of-life discussions curb readmissions, aggressive care

With the specialty growing exponentially in recent years, hospitals must carefully implement palliative care and integrate it with other services, according to the American Hospital Association (AHA) and Center to Advance Palliative Care (CAPC).

In the past decade, hospital palliative care has more than doubled at a 138 percent, according to the CAPC.

Recent research shows the specialty focused on serious illness, end-of-life care and pain relief can not only improve patient experience but also quality outcomes.

At Virginia's Inova Health System, patients who receive palliative services have lower readmission rates at 5 percent to 8 percent, compared to the national 20 percent of Medicare patients. The hospital screens all patients at admission to identify high-risk patients for readmission, ensuring that palliative care specialists are part of the planning process, according to an AHA-CAPC report.

Even more, palliative care can reduce aggressive care, according to separate research published last week in the Journal of Clinical Oncology. Patients who have end-of-life discussions with their physicians about palliative care before the last 30 days of life were less likely to receive aggressive measures, such as chemotherapy or acute care.

AHA-CAPC recommends hospitals:

  • Create a planning committee of administrators and clinicians to maximize palliative care. For instance, Banner Health formed a palliative care advisory board, charged with developing a clinical and business model.
  • Complete a needs assessment of palliative services
  • Review priorities of palliative services that improve outcomes
  • Collect data for baseline measurement
  • Communicate with peer institutions that have been successful in integrating palliative care into ICUs, emergency departments, hospitalist programs and outpatient services
  • Develop a strategic plan and budget

For more information:
- see the AHA-CAPC report (.pdf)
- here's the Journal of Clinical Oncology study abstract

Related Articles:
Palliative care cuts costs as much as 67%
Palliative care moves beyond hospital setting
Palliative care offers return on investment
In-hospital palliative care quadruples
Joint Commission: Palliative care should be open to all; first certifications announced