Supportive responsiveness from the PCCS for families who have experienced critical incidents or who have unanswered questions or resentment about treatment may be an important consideration to alleviate later emotional burden.
Cost avoidance is realized when patients transfer to an APCU even when conservative pre-APCU cost measures are used and when patients with varying diagnoses and discharge outcomes are included. This study demonstrates a replicable methodology for estimating the financial impact of an APCU.
The widespread need for palliative care has prompted the development of hospital-based palliative care consult services to provide a more interdisciplinary approach to managing advanced illness and end-of-life concerns. Establishing a successful consult service is a challenging task. This is a descriptive study of the development of a palliative care consult service (PCCS) within a non-profit, multi-hospital health system, and the five successful strategies used to optimize growth over the first five years. The PCCS is a mobile interdisciplinary team established to provide accessible, comprehensive end-of-life care and symptom management to patients with advanced illness within the health care system. Critical to its success, the team developed and maintained a database to document growth and ensure continuous quality improvement. A description of this database is provided, along with current performance outcomes. The program has prospered since its inception in 2002, with a 47% average annual growth over the first five years. The PCCS now averages 110 consults per month and has treated more than 3500 patients. This growth can be directly attributed to the five key strategies that have been used to plan, develop, and expand the program.
patients and families, the PCCS may help reduce the potential ethical conflicts that arise at the end-of-life, particularly regarding differing opinions in the provision of life-sustaining treatment.
Background. Outpatient palliative care continues to evolve with scant description in the literature; few studies present patient outcomes and no studies present system outcomes. Summa's Hospice and Palliative Care Services opened an outpatient palliative care clinic (OPPCC) in January 2008. Background. The purpose of this study is to retrospectively describe the population and measure the OPPCC's system impact through pre vs. post OPPCC visit and OPPCC patient vs. control group cost analyses. Method. OPPCC patients and matched controls seen between 1/1/2008 e 6/30/2010 were identified through electronic health records (EHR). Control patients were matched on age within 10 years and primary diagnosis. An EHR chart review identified primary diagnosis, up to 5 co-morbidities, source of referral, and primary care physician (PCP), number of PCP and urgent office visits. The number of Emergency Department (ED) visits, hospitalizations, and total hospital length of stay during the study period were obtained from the hospital's EHR. The hospital's finance department provided cost data for ED visits and hospitalizations. Data were analyzed using SPSSÓ paired samples and independent groups t-tests.
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