Hospitalized patients with advanced cancer usually require symptom management and supportive care; however, some are not referred for palliative care (PC) services. Researchers conducted a study at Mount Sinai Hospital in New York City to examine the use of standardized criteria, or triggers, for PC consultation in the hospital setting.
Patients received an automatic PC consultation if they met 1 or more of the eligibility criteria, which included having an advanced solid tumor, prior hospitalization within 30 days, hospitalization duration greater than 1 week, and presence of active symptoms.
Sixty-five patients in the intervention group were compared with 48 patients in a control group receiving usual care. PC consultations increased from 39% to 80% and hospice referrals increased from 14% to 26%. Declines in the 30-day readmission rate were observed, and fewer patients received chemotherapy following hospital discharge. There also were significant increases in referrals for supportive measures.
The researchers noted that by removing the burden of subjective identification of PC needs, a more objective assessment of patients and their families’ needs can be made. They concluded that the standardized use of triggers for PC consultation is associated with a substantial impact on multiple quality measures. The study findings are available here.