Background: Due to a large volume of acute care patients evidencing need for palliative care services and an organizational desire to support acute care staff as they provide such services, the Hospice Program at the Visiting Nurse Service of New York (VNSNY) initiated a palliative care consultation pilot project in the spring of 2004. The goal of this project is to improve patient care through closer communication and care coordination between hospice and acute care clinical staff. The Center for Home Care Policy and Research is collaborating with the Hospice Program to evaluate the effectiveness of providing palliative care consultation on home health outcomes and service delivery.

Purpose: This study has three main objectives. The first is to determine barriers to internal hospice referrals from the perspective of acute care COCs – emphasis not limited to racial/ethnic minority patient population. The second objective is to build an effective intervention partnership model between Hospice Coordinators of Care (COCs) and acute care COCs. The third objective is to provide palliative care consultation to acute care COCs (and teams) to result in improved patient pain and symptom management, advanced care planning, emotional adjustment, and quality of life.

Study Design: Case-control intervention study

Anticipated Project Results:

1. Improved understanding of factors that affect internal hospice referral and enrollment patterns
2. Enhanced partnerships between hospice and acute care programs as demonstrated by increased number of referrals to hospice and increased LOS in the hospice program through earlier referral of eligible patients
3. Demonstrated improvements in quality of palliative and end-of-life care for patients including pain and symptom management, advanced care planning, emotional adjustment, and quality of life, with feedback provided to acute care teams

Conclusions: Forthcoming.

Publications: Forthcoming.

Sponsor: The Starr Foundation