Hospitalists: Strategies for Caring for People with Serious Illness

Last Reviewed: March 4, 2019

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

Last Updated: February 28, 2019

The value of skills training for hospitalists.

download

Navigating the CAPC Online Curriculum: A Guide for Hospitalists

Last Updated: May 1, 2019

CAPC courses and tools for hospitalists.

download

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

Last Updated: February 3, 2019

Journal of Hospital Medicine, December 2017.

download

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

Last Updated: February 27, 2019

Journal of Hospital Medicine, June 2018.

view

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

Last Updated: February 27, 2019

Journal of Hospital Medicine, December 2018.

view

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

Last Updated: January 15, 2015

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

start the course

Relief of Suffering Across the Disease Trajectory

Last Updated: July 2, 2019

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

view

Pain Assessment and Documentation Tool (PADT)

Last Updated: February 3, 2019

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

view

PHQ-4: Validated Screening Tool for Anxiety and Depression

Last Updated: January 29, 2019

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

view

GAD-7 Anxiety Scale

Last Updated: February 3, 2019

Measure for assessing generalized anxiety disorder.

download

Pain Assessment in Advanced Dementia (PAINAD)

Last Updated: February 3, 2019

Tool to assess pain in cognitively impaired patients.

view

The Global Deterioration Scale (GDS)

Last Updated: January 29, 2019

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

view

Opioid Risk Tool (ORT)

Last Updated: February 3, 2019

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

view

Patient Identification and Assessment

Last Updated: March 4, 2019

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

view

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

Last Updated: March 4, 2019

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

view

Supporting the Family Caregiver: The Burden of Serious Illness

Last Updated: March 10, 2016

Assessing and supporting caregivers of people with serious illness.

start the course

Communication Skills Pathfinder

Last Updated: February 3, 2019

One-door portal for clinician communication skills training.

view

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.

MEMBERS ONLY locked

Referral Criteria for Specialty Palliative Care

Last Updated: February 3, 2019

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

Last Updated: July 1, 2019

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

start the course

Course 4: Assessing Risk for Opioid Substance Use Disorder

Last Updated: July 1, 2019

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

start the course

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

Last Updated: July 1, 2019

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

start the course

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

Last Updated: July 1, 2019

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

start the course

Course 14: Pain Management: Putting it All Together

Last Updated: July 1, 2019

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

start the course
MEMBERS ONLY locked

Prescribing Opioids: A Pocket Reference

Last Updated: April 26, 2019

Opioid pocket reference for providers including safe starting doses, equianalgesic chart, and standard dosing strengths. Center to Advance Palliative Care, 2016.

Pain Assessment and Documentation Tool (PADT)

Last Updated: February 3, 2019

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

view

Opioid Risk Tool (ORT)

Last Updated: February 3, 2019

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

view

Symptom Management

Last Updated: March 4, 2019

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

view

PHQ-4 Validated Screening Tool for Anxiety and Depression

Last Updated: February 3, 2019

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

download

GAD-7 Anxiety Scale

Last Updated: February 3, 2019

Measure for assessing generalized anxiety disorder.

download

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

Last Updated: February 3, 2019

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

view

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

Last Updated: March 10, 2016

Assessing and supporting caregivers of people with serious illness.

start the course
MEMBERS ONLY locked

Hospital Discharge Checklist

Last Updated: February 3, 2019

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

Related Toolkits See all 5 toolkits

Get the latest updates in your inbox!