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What an interesting question. At our institution, “high-impact” refers to areas where we can have the most effect on clinical, satisfaction, operational and financial outcomes. For example, working to ensure that palliative care consultations occur as early as possible in the course of hospitalization is one means of maximizing our impact. When we see a patient on hospital day 1, vs hospital day 8, it means that patient and their family has access to the clinical, communication, care coordination, psycho-social and spiritual expertise of the PC team from the earliest moment possible. As a result, symptoms would be addressed sooner, goals of care would be clarified sooner, questions about the benefits and burdens of treatments would be answered sooner, non-beneficial bed days and / or ICU days could be avoided, and hospital costs would be lower. At our hospital that counts as high-impact.
Hope that helps. I’m interested to see what others say.
Regards,
Kathleen Kerr
Senior Analyst
University of California San Francisco, Palliative Care Leadership Center