Interdisciplinary Rounds on a Hospitalist Service: Impact on Palliative Care Measures, Quality, and Utilization Outcomes

J Nurs Care Qual. 2019 Oct/Dec;34(4):295-300. doi: 10.1097/NCQ.0000000000000385.

Abstract

Background: Despite growth in service availability, palliative care (PC) referrals are often underutilized or delayed, which may compromise patient outcomes.

Local problem: Underutilized or delayed PC referrals among hospitalized adults prompted this project aimed at improving PC measures, quality, and utilization outcomes.

Methods: Data extracted from the electronic medical record were used to identify needed improvements in PC.

Intervention: Interdisciplinary rounds (IDRs) were implemented on the hospitalist service in a nonintensive care setting.

Results: Following implementation, median time to PC referral decreased by 2 days. Length of stay (LOS), direct cost, and 30-day mortality also decreased. Postintervention patients were more likely to transition home compared with another facility.

Conclusions: Results support IDRs as a mechanism to improve time to PC referral, decrease LOS, direct cost, and 30-day mortality among hospitalized adults. A more objective method of identifying patients with unmet PC needs may be warranted.

MeSH terms

  • Aged
  • Electronic Health Records / statistics & numerical data
  • Female
  • Hospitalists*
  • Humans
  • Length of Stay / economics
  • Male
  • Palliative Care*
  • Patient Care Team*
  • Quality Improvement*
  • Referral and Consultation / statistics & numerical data*
  • Teaching Rounds*