Bringing Home into the Academic Medical Center: Inpatient Hospice with a Community Partner (QI612)

Abstract

•Describe multiple models to deliver inpatient hospice.•Evaluate a general inpatient care (GIP) hospice program using a set of metrics. Often, patients with devastating and serious illnesses are referred to academic medical centers for expert-level care. After evaluation, many patients and families elect comfort care, and patients spend the final days of their lives within an academic center's hospital walls. There were not options for inpatient hospice care in our area, and a review of our process showed inconsistent end-of-life care processes and bereavement support. Literature shows that including palliative care treatment plans at the end of life can reduce patient suffering. Families report connecting with support providers during a period of bereavement to be helpful. To address the variability in care and family support, we developed an inpatient hospice service to streamline and standardize end-of-life care at our hospital. Develop an inpatient hospice program to streamline end-of-life care for dying patients. Develop an inpatient hospice program with a community partner to provide comprehensive bereavement to families after the death of a loved one. Evaluate patient and family satisfaction with end-of-life care via interview and a 30-day postdischarge survey. We partnered with a community hospice company to provide nursing, social work, and chaplain support to dying patients. We developed an evidence-based comfort measures order set for all dying patients in our hospital and provided end-of-life symptom management education to the care team. We then designed a process for a smooth transition to inpatient hospice and monitored demographics for all patients. Patient families, when present, were interviewed with predetermined questions to evaluate their experience. Surveys were sent at 30 days. Forty-four patients have been admitted. Of these, 60% are men and 40% are women. Over 90% of these patient families report that they received a high level of care at the end of life. Implementation of an inpatient hospice program in an academic center with a community partner is successful with high patient and family satisfaction.