A Hospitalist-Designed, Nurse-Driven Palliative Care Model in a Community Hospital
Published in The Hospitalist, this article describes a 90-day pilot at an 86-bed community hospital in which a hospitalist and a nurse care manager implemented a nurse-driven palliative care workflow in the absence of an on-site specialty team. The model expanded early goals-of-care conversations, advance care planning, and hospice referrals through structured patient identification, standardized documentation, and multidisciplinary coordination. Results showed improved completion of advance directives and code status documentation, earlier palliative engagement, and stronger alignment between patient values and care decisions, demonstrating a scalable approach to delivering palliative care principles in resource-limited settings.