Palliative Care Consultation Trajectories

by Elissa Kozlov

Institution: Washington University in St. Louis
Year: 2012
Keywords: Palliative Care; Service Utilization; End-of-Life; Psychology
Record ID: 1992831
Full text PDF: http://openscholarship.wustl.edu/etd/1113



In 2008, the Veterans Association: VA) mandated that all VA hospitals have a palliative care consult team: PCCT) to provide services to veterans with life-limiting illness. PCCTs within the VA are new, so little is known about their efficacy and utilization. The purpose of this study is to examine the timing of PCCT consultations and responses; document and categorize types and rates recommendations; determine rates at which recommendations are implemented; and identify factors related to if recommendations are made and implemented. This electronic medical records review study examined 200 initial palliative care consultations conducted in one VA hospital between January 1st, 2009 and December 31st, 2010. The median interval between admission and consultation was 5 days. The PCCT made recommendations for 111 patients: 55.5%). The mean number of recommendations per patient was 1.44: SD = 1.81). The original care team implemented 57% of the recommendations. In this medical center, the PCCT offers a range of recommendations to enhance the care of patients with life-limiting illness, though these recommendations are implemented at differential rates. In order for PCCTs to attain maximum effectiveness, more research is needed to understand the interpersonal and organizational factors that influence how PCCT teams function within healthcare systems.