SHM Converge Scientific Abstract ePoster Gallery-Evaluation of Palliative Care Team Integration Into an Inpatient Hematology-Oncology Unit

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This retrospective pre/post study evaluated a new inpatient palliative care model at an academic medical center, where a dedicated palliative care consult team was geographically embedded within the medical oncology service and joined daily interdisciplinary rounds. The goal was to assess effects on resource use, intensity of care, and transition to hospice among adult oncology inpatients.<br /><br />The study compared patients admitted before implementation (6/1/22–11/30/22; n=500) with those admitted after implementation (1/1/23–6/30/23; n=505). Outcomes included length of stay, total hospital charges, 30-day readmissions, ICU utilization, hospice-related measures, and timing of palliative care consultation. Statistical comparisons used chi-square and Wilcoxon rank-sum tests.<br /><br />Results showed that the embedded model significantly increased palliative care consultation rates (31.4% to 42.2%) and was associated with more hospice referral orders (0% to 2.4%). However, it did not significantly change length of stay, 30-day readmissions, comfort-measures orders, discharge to hospice, or time from admission to palliative care consult. Total hospital charges increased significantly after implementation. Unexpectedly, ICU admissions also increased.<br /><br />Overall, the intervention improved access to palliative care but did not reduce utilization outcomes or readmissions. The authors conclude that inpatient oncologic care is complex and that many patient-centered outcomes are not well captured in the EHR. They note limitations including a single-center design, a changing workflow during the study period, and inability to account for other simultaneous interventions.

Asset Subtitle

Naomi Hodde

Meta Tag

Author List Amanda Kennedy, Bradley Tompkins, Naomi Hodde, Sara Brennan

Category Research

Concept Palliative Care

Concept Inpatient Oncology

Concept Palliative Care Consult Team

Concept Geographically Embedded Model

Concept Care Delivery

Distinguished Non-Finalist

Presenter Organization University of Vermont

Presenting Author Naomi Hodde

Track Consultative Medicine

Keywords

palliative care

inpatient oncology

consult team

interdisciplinary rounds

resource utilization

length of stay

hospice referral

ICU utilization

retrospective study

academic medical center

Palliative Care

Inpatient Oncology

Palliative Care Consult Team

Geographically Embedded Model

Care Delivery