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CAPC Palliative Care Discussion Forum
Palliative Care and Emergency Medicine

Next Reply: Re:ED Palliative Care Policy
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Post ED Palliative Care Policy
Author: jlewis
Date: Jun 6, 2011 2:59 pm
Does anyone have a PC policy from which I can glean information about successful protocols for palliative care consults in the ED? I work in a small rural, critical access hospital and am trying to develop a PC program for our ED. Many thanks!!
Replies: order by [Date] [Author] [Subject]
Re:ED Palliative Care Policy (by cfoster on 06/07/2011)
I also work in a rural critical access hospital and am working on expanding our PC services to the ED. I have used the ICU-PAL project as a starting point. I suggest educating the staff on PC principles and finding out what their needs are/what types of pts. you are wishing to see as a consult. Do not have a 'policy', just a good working relationship with staff. Also, review Dr. David Weissman's information on consultation triggers.
Re:ED Palliative Care Policy (by sjcrump on 06/10/2011)
Thank you for your post. It is challenging to suggest protocols when one doesn't know the system. Does protocol mean consult trigger? ED education? I think our effort to try to be notified for all hospice patients is a reasonable trigger. Our consult policy is simply that we respond to the ED when called. We do a consult as soon as possible during daytime hours. In our consult we are able to help with treatment recommendation, communication and care planning, discharge planning (especially back to hospice), and admission to our PCCU or helping give recommendations to another admitting service. To my knowledge we do not have a specific ED policy, protocol, or procedure other than a hospice patient trigger - for our nurse coordinator to be notified for review and to ask the physician if a full consult is acceptable.
Posted by Sandra Joyce Crump, RN, BSN, MBA
Palliative Care Leadership CentersTM
The University of Alabama in Birmingham
on behalf of:
Ryan R. Nash, MD, MA
Assistant Professor
UAB Center for Palliative and Supportive Care
+ Re:ED Palliative Care Policy (by TammieQuest on 06/13/2011)
Help is on the way! We will soon be introducing IPAL-EM, similar to the IPAL-ICU project specific for the emergency department. For one example - check out Denise Waugh's project focused on palliative consultation in the ED - Journal of Palliative Medicine. August 2010, 13(8): 936-936. We are in the process of surveying programs around the nation for models of PC/ED integration. The IPAL-EM team is looking for new programs/models for dissemination. Anyone reading, please post if you have a model for you are willing ot share.

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