The following is a summary of “Emergency department hospice care pathway associated with decreased ED and hospital length of stay,” published in the February 2024 issue of Emergency Medicine by Wendel, et al.

Despite growing evidence supporting the benefits of hospice and palliative care interventions in emergency department (ED) settings, there is limited research on effectively identifying patients who could benefit from hospice care. For a study, researchers sought to assess the impact of implementing a clinical care pathway on identifying patients in ED who may benefit from hospice care within an academic medical center.

A clinical pathway for patients in ED with potential hospice needs was introduced, digitally embedded in the electronic health record, and accessible to ED physicians, advanced practice providers (APPs), and staff in a non-interruptive manner. Patient and visit characteristics were compared for the six months before and after pathway implementation.

Following pathway implementation, more patients were identified as suitable for hospice care, leading to a median decrease of 2.9 hours in ED length of stay for qualifying patients. The utilization of social work consultation for hospice evaluation increased, and more patients were discharged from the ED with hospice services. While more patients were identified with end-of-life care needs, there was an increase in the number of patients admitted to the hospital. However, a higher proportion of these admissions were under observation status, resulting in a median decrease of 18.4 hours in admission length of stay.

Implementing a non-interruptive, digitally embedded clinical care pathway facilitated the identification of patients who could benefit from hospice care in the ED. This led to increased social work consultation and hospice eligibility identification, as well as reduced ED and hospital admission lengths of stay for admitted patients.

Reference: sciencedirect.com/science/article/abs/pii/S0735675723006307