Impact of Systematic Palliative Care Screening Program Across a Tertiary Care Hybrid Health System (418-B)

Abstract

1.Recognize the benefits of a system wide palliative care screening program.2.Identify strategies to implement a case management based palliative care screening program.3.Recognize the components of electronic palliative care screening tool. Across the care continuum, there is an increasing need for systematic palliative care and hospice screening to meet the needs of all patients. Historically, many post discharge scoring systems and strategies have been developed to stratify patient need for palliative and hospice care. A model for case management based electronic palliative care screening and referral was developed and evaluated in a hybrid academic and community health system. A multidisciplinary palliative care team and governance structure was created with representation from all five hospitals of a hybrid health system in Northern Virginia. An evidence-based palliative care screening tool was developed and implemented in Allscripts, an electronic case management database. Domains of the tool included both general and ICU elements. Reporting functions in Allscripts provided the capability to measure both the screening compliance in identified subsets and utilization of primary and secondary palliative care and hospice. A palliative care scorecard was created to measure the program's impact on quality, service and community metrics. There was a high utilization of the palliative care screening tool by case managers and social workers, which resulted in increased access and referrals to palliative and hospice care; decreased time from admission to palliative care consultation; and a cost savings. Systematic palliative care screening has significant impact on the delivery of high quality care. The palliative care screening program would not have been successful without support from Inova's senior leadership. The screening program resulted in improved communication between case management, physicians, nurses, and other health care providers. Continued success from the palliative care screening tool would provide the rationale for expanding palliative care services and screening initiatives into other care settings, such as home health and nursing homes.