Impact of a new palliative care consultation team on opioid prescription in a University Hospital

Objective: To identify factors that hinder or facilitate the palliative care consultation team’s (PCCT) successful collaboration with other providers from the perspectives of both PCCT and nonpalliative specialists. Methods: Qualitative study, including semistructured interviews with PCCT and nonpalliative care providers from various specialties at 4 Midwestern hospitals. Interviews were audio-recorded and transcribed into written text documents for thematic analysis. Palliative care consultation team (n = 19) and nonpalliative care providers (n = 29) were interviewed at their respective hospital sites or via telephone. Palliative care consultation team providers included physicians, nurse practitioners, registered nurses, social workers, and one chaplain. Specialists included critical care physicians, surgeons, hospitalists, nephrologists, oncologists, and cardiologists. Results: Six themes emerged reflecting barriers to and facilitators of successful collaboration between the PCCT and other providers. Primary barriers included attitudes about palliative care, lack of knowledge about the role of the PCCT, and patient and family resistance. Facilitators included marketing of the palliative care service and education about the expertise of the PCCT. Conclusion: In order to engage in more effective collaboration with other specialty providers, the PCCT may consider strategies including structured educational interventions, increased visibility in the hospital, and active marketing of the utility of palliative care across disciplines.

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Validation of the Palliative Prognostic Index and Palliative Prognostic Score in a Palliative Care Consultation Team Setting for Patients With Advanced Cancers in an Acute Care Hospital in Japan

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909113506034 ◽

2013 ◽

Vol 31 (7) ◽

pp. 730-734 ◽

Cited By ~ 7

Author(s):

Hiroshi Sonoda ◽

Takashi Yamaguchi ◽

Mina Matsumoto ◽

Ko Hisahara

Keyword(s):

Palliative Care ◽

Prognostic Score ◽

Prognostic Index ◽

Acute Care Hospital ◽

Care Hospital ◽

Palliative Care Consultation ◽

Palliative Prognostic Index ◽

Consultation Team ◽

Care Consultation ◽

Team Setting

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Impact of a Palliative Care Consultation Team on Cancer-Related Symptoms in Advanced Cancer Patients Referred to an Outpatient Supportive Care Clinic

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2010.03.017 ◽

2011 ◽

Vol 41 (1) ◽

pp. 49-56 ◽

Cited By ~ 99

Author(s):

Sriram Yennurajalingam ◽

Diana L. Urbauer ◽

Katie L.B. Casper ◽

Cielito C. Reyes-Gibby ◽

Ray Chacko ◽

...

Keyword(s):

Palliative Care ◽

Supportive Care ◽

Cancer Patients ◽

Advanced Cancer ◽

Advanced Cancer Patients ◽

Care Clinic ◽

Palliative Care Consultation ◽

Consultation Team ◽

Care Consultation ◽

Outpatient Supportive Care

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Palliative care consultation team: symptom relief in first 48 hours of hospitalization

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2019-0391 ◽

2020 ◽

Vol 73 (6) ◽

Author(s):

Magda Aparecida dos Santos Silva ◽

Marcio Augusto Diniz ◽

Ricardo Tavares de Carvalho ◽

Toshio Chiba ◽

Cibele Andrucioli de Mattos-Pimenta

Keyword(s):

Palliative Care ◽

Pain Relief ◽

Symptom Relief ◽

Symptom Assessment ◽

Assessment System ◽

Point Reduction ◽

Palliative Care Consultation ◽

Symptom Intensity ◽

Consultation Team ◽

Care Consultation

ABSTRACT Objective: To compare the relief of symptoms provided by palliative care consultation team (PCCT) compared to the traditional care team (TC), in patients with advanced cancer in the first 48 hours of hospitalization. Method: Allocated to PCCT Group and TC Group, this study assessed 290 patients according to the Edmonton Symptom Assessment System (ESAS) within the first 48 hours of hospitalization. The main outcome was a minimum 2-point reduction in symptom intensity. Results: At 48 hours, the PCCT Group had a 2-point reduction in the mean differences (p <0.001) in pain, nausea, dyspnea, and depression; and TC Group, on nausea and sleep impairment (p <0.001). Multiple Logistic Regression found for the PCCT Group a greater chance of pain relief (OR 2.34; CI 1.01-5.43; p = 0.049). Conclusion: There was superiority of the PCCT Group for pain relief, dyspnea and depression. There is a need for more studies that broaden the understanding of team modalities.

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Establishment of a Palliative Care Consultation Service (PCCS) in an Acute Hospital Setting

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17144977 ◽

2020 ◽

Vol 17 (14) ◽

pp. 4977

Author(s):

Peter Tom Engel ◽

Tharshika Thavayogarajah ◽

Dennis Görlich ◽

Philipp Lenz

Keyword(s):

Palliative Care ◽

Hospital Setting ◽

University Hospital ◽

Consultation Service ◽

Palliative Care Consultation ◽

Single Center Study ◽

Care Consultation ◽

Ward Rounds ◽

Loss Of Appetite ◽

Palliative Care Consultation Service

Background and study aims: Acute health service requires focused palliative care (PC). This study was performed to provide guidance for the establishment of a palliative care consultation service (PCCS). Patients and methods: This study was conceived as a retrospective single-center study for observing, analyzing and evaluating the initial setup of a PCCS from 1 May 2015 to 31 May 2018. Patients from Muenster University Hospital with advanced life-limiting diseases, identified to require PC, were included. Results: PCCS was requested from various departments, for between 20 and 80 patients per month, corresponding to a total of 2359 for the study period. Requests were highest in internal medicine (27.3%), gynecology (18.1%) and radiotherapy (17.6%). Time to referral was significantly shorter in departments with special PCCS ward rounds (6 ± 9 vs. 12 ± 22 days, p < 0.001). The most frequently reported symptoms were fatigue, pain and loss of appetite. Pain was frequently localized in the stomach (20.4%), back (17.1%), or in the head and neck area (14.9%). After the first PCCS consultation, 254 patients (90%) reported sufficient pain relief after 48 h. An introduction/modification of painkiller medication, which was recommended for 142 inpatients, was implemented in 57.0% of cases by the respective departments. Overall, the direct realization of PCCS recommendations reached only 50% on average. Conclusions: Besides an analysis of the ability to address the symptoms of the referred patients by the PCCS, this study highlights the importance of the interaction between PCCS and other departments. It further elucidates the role and possibilities of this service both in regular ward rounds and individual staff contacts.

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Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?

Palliative Medicine ◽

10.1177/0269216317690098 ◽

2017 ◽

Vol 31 (4) ◽

pp. 378-386 ◽

Cited By ~ 44

Author(s):

Peter May ◽

Melissa M Garrido ◽

J Brian Cassel ◽

Amy S Kelley ◽

Diane E Meier ◽

...

Keyword(s):

Palliative Care ◽

Cohort Study ◽

Length Of Stay ◽

Advanced Cancer ◽

Intervention Group ◽

Cost Savings ◽

Early Palliative Care ◽

Palliative Care Consultation ◽

Consultation Team ◽

Care Consultation

Background: Studies report cost-savings from hospital-based palliative care consultation teams compared to usual care only, but drivers of observed differences are unclear. Aim: To analyse cost-differences associated with palliative care consultation teams using two research questions: (Q1) What is the association between early palliative care consultation team intervention, and intensity of services and length of stay, compared to usual care only? (Q2) What is the association between early palliative care consultation team intervention and day-to-day hospital costs, compared to a later intervention? Design: Prospective multi-site cohort study (2007–2011). Patients who received a consultation were placed in the intervention group, those who did not in the comparison group. Intervention group was stratified by timing, and groups were matched using propensity scores. Setting/participants: Adults admitted to three US hospitals with advanced cancer. Principle analytic sample contains 863 patients ( nUC = 637; nPC EARLY = 177; nPC LATE = 49) discharged alive. Results: Cost-savings from early palliative care accrue due to both reduced length of stay and reduced intensity of treatment, with an estimated 63% of savings associated with shorter length of stay. A reduction in day-to-day costs is observable in the days immediately following initial consult but does not persist indefinitely. A comparison of early and late palliative care consultation team cost-effects shows negligible difference once the intervention is administered. Conclusion: Reduced length of stay is the biggest driver of cost-saving from early consultation for patients with advanced cancer. Patient- and family-centred discussions on goals of care and transition planning initiated by palliative care consultation teams may be at least as important in driving cost-savings as the reduction of unnecessary tests and pharmaceuticals identified by previous studies.

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