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Emergency department palliative care pathway evaluation
Descriptive
TitleInfo
Title
Emergency department palliative care pathway evaluation
Name
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Boyle
NamePart
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Susan J.
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Susan J. Boyle
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author
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Barberio
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Judith
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Judith Barberio
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Advisory Committee
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chair
Name
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McKie
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Gillian
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Gillian McKie
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Advisory Committee
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outside member
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Rutgers University
Role
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degree grantor
Name
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NamePart
School of Nursing - RBHS
Role
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school
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Text
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theses
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ETD doctoral
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2021
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2021-01
Language
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English
Abstract
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Purpose: To evaluate the outcomes of an emergency department (ED) based palliative care program, with respect to its impact on healthcare utilization.
Methodology: A retrospective chart review utilizing the Re-Aim framework was conducted to evaluate the outcomes of a palliative care (PC) program initiated in the emergency department of a tertiary academic healthcare center in the northeastern United States. This pilot study reviewed the charts of 100 patients with a life-limiting serious illness and compared the outcomes of patients who received a PC referral in the ED (n=50) versus a similar number (n=50) who did not receive a PC referral in the ED. The outcomes examined included hospital length of stay (LOS), critical care LOS, number of specialty consults, number of advanced procedures (arterial line, central line, intubation, cardiopulmonary resuscitation), referral to hospice and 30-day readmissions.
Results: Patients with a life-limiting diagnosis who received a referral to PC in the ED had significantly lower healthcare utilization rates, increased change in code status, increased time on the palliative care floor and increased referral to hospice than the control group (p < .05).
Implications for practice: This outcomes evaluation shows the impact of an ED-based PC program, supports the current nurse-driven ED initiative, and forms the basis for future program improvements.
Methodology: A retrospective chart review utilizing the Re-Aim framework was conducted to evaluate the outcomes of a palliative care (PC) program initiated in the emergency department of a tertiary academic healthcare center in the northeastern United States. This pilot study reviewed the charts of 100 patients with a life-limiting serious illness and compared the outcomes of patients who received a PC referral in the ED (n=50) versus a similar number (n=50) who did not receive a PC referral in the ED. The outcomes examined included hospital length of stay (LOS), critical care LOS, number of specialty consults, number of advanced procedures (arterial line, central line, intubation, cardiopulmonary resuscitation), referral to hospice and 30-day readmissions.
Results: Patients with a life-limiting diagnosis who received a referral to PC in the ED had significantly lower healthcare utilization rates, increased change in code status, increased time on the palliative care floor and increased referral to hospice than the control group (p < .05).
Implications for practice: This outcomes evaluation shows the impact of an ED-based PC program, supports the current nurse-driven ED initiative, and forms the basis for future program improvements.
Subject
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Topic
Palliative care
Subject
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Topic
Emergency department
Subject
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Topic
Healthcare utilization
Subject
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Topic
Outcomes evaluation
Subject
(authority = local)
Topic
Re-Aim framework
Subject
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Topic
Post-Master's DNP Practice
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Title
Rutgers University Electronic Theses and Dissertations
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ETD
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ETD_11334
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application/pdf
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text/xml
Extent
1 online resource (81 pages) : illustrations
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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NjNbRU
Identifier
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doi:10.7282/t3-x9f3-g256
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
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Boyle
GivenName
Susan
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Permission or license
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2020-12-12 17:08:58
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Name
Susan Boyle
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Copyright holder
Affiliation
Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Embargo
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2021-01-31
DateTime
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2023-01-31
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after January 31st, 2023.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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