In the busy day of a hospitalist, one or two complex patients can lead to a backlog in daily rounds, delayed discharges, and inadequate time to communicate with patients and families. Palliative care, named as a core competency for hospitalists by the Society for Hospital Medicine (SHM), aims to improve quality of life for patients and families living with serious illness and complex need through skilled communication, pain and symptom management, and care coordination.

For many patients, hospitalists are in the best position to manage symptoms and have conversations about care priorities. Clinical training allows hospitalists to efficiently address common gaps in care for people with serious illness. For patients with the most complex needs, earlier palliative care consult leads to improved patient outcomes, improved clinician satisfaction, and reduced hospital utilization and costs.

Visit SHM's Resource Room for Palliative Care to access additional resources specific to hospital medicine strategies and hospitalists.

Download a course catalog with information about continuing education credits and ABIM MOC points for all CAPC courses here.

What’s in the Toolkit

Learn how palliative care can help both patients and hospitalists.

Hospital Medicine Strategies: Caring for the Seriously Ill

The value of skills training for hospitalists.

Navigating the CAPC Online Curriculum: A Guide for Hospitalists

CAPC courses and tools for hospitalists.

Improving Quality of Care for Seriously Ill Patients: Opportunities for Hospitalists

Journal of Hospital Medicine, December 2017.

Update in Hospital Palliative Care: Symptom Management, Communication, Caregiver Outcomes, and Moral Distress

Journal of Hospital Medicine, June 2018.

A Model to Improve Hospital-Based Palliative Care: The Palliative Care Redistribution Integrated System Model (PRISM)

Journal of Hospital Medicine, December 2018.

Training in core pain and symptom management, communication, and care coordination allows hospitalists to efficiently identify and address common gaps in care for people with serious illness and to refer patients to palliative care when appropriate.

An In-Depth Look At Palliative Care And Its Services

Defining palliative care, which patients need it, how it is delivered, and how palliative care differs from hospice.

Relief of Suffering Across the Disease Trajectory

Addressing factors that contribute to quality of life for people with serious illness and their families.

Pain Assessment and Documentation Tool (PADT)

Validated instrument to assess pain intensity and impact on function over time.

PHQ-4 Validated Screening Tool for Anxiety and Depression

Brief (4-question) screening tool for anxiety and depression.

GAD-7 Anxiety Scale

Measure for assessing generalized anxiety disorder.

Pain Assessment in Advanced Dementia (PAINAD)

Tool to assess pain in cognitively impaired patients.

The Global Deterioration Scale (GDS)

Stages of cognitive function for those suffering from a degenerative dementia such as Alzheimer's disease.

Opioid Risk Tool (ORT)

Validated 5-question assessment tool designed to predict which patients are at risk for opioid substance use disorder.

Patient Identification and Assessment

Toolkit for finding the right patients at the right time to address gaps in care.

According to SHM's Core Competencies in palliative care, all hospitalists should have the skills to:

  • Lead culturally sensitive communications with patients, families, and colleagues about prognosis and goals of care
  • Provide counseling on advance care planning and alignment of care plans with patient preferences

Clinicians hoping to improve their communication skills or clinical champions positioned to improve staff competency in serious illness communication should refer to SHM's Improving Communication about Serious Illness Implementation Guide.

Communication Skills

Techniques for communicating with patients and families about their serious illness and eliciting patient hopes, fears, and priorities for care.

Supporting the Family Caregiver: The Burden of Serious Illness

Assessing and supporting caregivers of people with serious illness.

Communication Skills Pathfinder

One-door portal for clinician communication skills training.

According to SHM's Core Competencies in palliative care, hospitalists are expected to coordinate goals of care and the treatment plan among the treating team, including primary care physicians and specialty consultants.

Referral Criteria for Specialty Palliative Care
MEMBERS ONLY locked

Checklist of triggers for referral to a specialty palliative care team.

Hospitalists are often called upon to provide first-line treatment for pain and other symptoms, including nausea, vomiting, dyspnea, delirium, and constipation.

Course 1: Comprehensive Pain Assessment

Conducting a comprehensive pain assessment to guide safe and effective treatment.

Course 4: Assessing Risk for Opioid Substance Use Disorder

Integrating routine risk assessment for substance use disorder when considering or using opioid therapy.

Course 5: Opioid Trials: Determining Design, Efficacy, and Safety

Designing a safe and effective opioid trial for the patient with serious illness.

Course 8: Monitoring for Opioid Efficacy, Side Effects, and Substance Use Disorder

Ongoing evaluation of opioid benefits, risks, and side effects for the patient with serious illness.

Course 14: Pain Management: Putting it All Together

Safe opioid prescribing for patients with serious illness, using the Federation of State Medical Boards (FSMB) Guidelines for the Chronic Use of Opioid Analgesics.

Prescribing Opioids: A Pocket Reference

Opioid pocket reference for providers including safe starting doses, equianalgesic chart, and standard dosing strengths. Center to Advance Palliative Care, 2019.

Pain Assessment and Documentation Tool (PADT)

Validated instrument to assess pain intensity and impact on function over time.

Opioid Risk Tool (ORT)

Validated 5-question assessment tool designed to predict which patients are at risk for opioid substance use disorder.

Symptom Management

Training curriculum and clinical tools for assessing and managing five common symptoms in patients living with serious illness.

PHQ-4 Validated Screening Tool for Anxiety and Depression

Brief (4-question) screening tool for anxiety and depression.

GAD-7 Anxiety Scale

Measure for assessing generalized anxiety disorder.

Update in Hospital Palliative Care: Symptom Management, Communication, Caregiver Outcomes, and Moral Distress

Research review for clinicians caring for hospitalized patients living with serious illness. Journal of Hospital Medicine, 2018.

Ensuring that hospital discharge plans are honored requires communication about care plans with primary care and other outpatient providers, as well as community services.

Supporting the Family Caregiver: The Burden of Serious Illness

Assessing and supporting caregivers of people with serious illness.

Hospital Discharge Checklist
MEMBERS ONLY locked

Practical tool for assuring safe discharge for patients living with serious illness.