July 27, 2020

Palliative care in the emergency department: A survey assessment of patient and provider perspectives

By ejschwartz

Emily Woods

Dr. Woods is an Emergency Physician at Mayo Clinic in Rochester and South-East Minnesota

Palliative care has been identified as an area of low outpatient referral from our emergency department, yet palliative care has been shown to improve the quality of patient’s lives.

This study investigates both provider and patient perspectives on palliative care for the purpose of identifying barriers to increased palliative care utilization within our healthcare system.

Two surveys were developed, one for patients and/or their caregivers and one for healthcare providers, including attending physicians, resident physicians and advanced practice providers.

This was a single-center study completed at a quaternary academic emergency department. A survey was sent to emergency medicine providers with 47% response rate. Research staff approached Emergency Department patients who had been identified to be high risk to fill out paper surveys with 76% response rate.

Only 28% of patients had already undergone palliative care, with an additional 25% interested in palliative care. Nearly half of the patients felt that they needed more resources to prevent hospital visits. Patients identified low understanding of palliative care and difficulty accessing appointments as barriers to consultation. Among providers, 98% indicated that they had patients who would benefit from palliative care. A majority of providers highlighted patient understanding of palliative care and access to appointments as barriers to palliative care. Notably, 52% of providers reported that emergency medicine provider knowledge was a barrier to palliative care consultation.

Despite emergency department patients’ self-identified need for resources and emergency medicine providers’ recognition of patients who would benefit from palliative care, few patients receive palliative care consultation.

See our full article: https://journals.sagepub.com/doi/full/10.1177/0269216320942453

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