Comparison of Quality of Care of Palliative Care Unit, Palliative Care Consultation Team and Non-Palliative Care Patients (SA510-A)

Abstract

1.Compare satisfaction of bereaved family members of patients who had received care from the palliative care unit versus the palliative care consult team.2.Understand differences in the quality of care provided by the palliative care unit and consult team.3.Understand the pros and cons of the palliative care unit and consult team Palliative care consult teams are becoming increasingly prevalent in U.S. hospitals. Interest in palliative care units is also growing. However, the impact of palliative care units as compared with consult teams on the quality of care received by patients and their families is not well understood. The goal of this study was to compare the impact of an inpatient palliative care unit with that of a consult team on quality of care at a large tertiary care hospital. Using the validated Bereaved Family Survey, we conducted quantitative telephone interviews of family members of patients who died at Mount Sinai Medical Center between March 2012 and January 2013 to assess quality of end-of-life medical care. Interviews were completed with 60 family members (enrollment rate, 56%): 30 family members in both the unit and consult team groups, respectively. Family members of patients who died on the palliative care unit were more satisfied with the care their loved one received, with 60% of palliative care unit patients' family members reporting that the patient's end-of-life medical care had been “excellent,” as compared with 21% of consult team patients' family members (P=0.003). Seventy-six percent of family members in the palliative care unit group reported satisfactory alignment of medical treatment with patient and family preferences, as compared with 50% of family members in the consult team group (P=0.047). Sixty-three percent of family members in the palliative care unit group reported adequate emotional support before the patient's death, as compared with 20% of family members in the consult team group (P<0.001). Our study shows that family members of patients who died while receiving care from the palliative care unit are more likely to report improved overall satisfaction, alignment of medical care with patient and family preferences, and emotional support before death as compared with the consult team.