Interdisciplinary Rounds on a Hospitalist Service: Impact on Palliative Care Measures, Quality, and Utilization Outcomes

BACKGROUND: Despite growth in service availability, palliative care (PC) referrals are often underutilized or delayed, which may compromise patient outcomes. LOCAL PROBLEM: Underutilized or delayed PC referrals among hospitalized adults prompted this project aimed at improving PC measures, quality, and utilization outcomes. METHODS: Data extracted from the electronic medical record were used to identify needed improvements in PC. INTERVENTION: Interdisciplinary rounds (IDRs) were implemented on the hospitalist service in a nonintensive care setting. RESULTS: Following implementation, median time to PC referral decreased by 2 days. Length of stay (LOS), direct cost, and 30-day mortality also decreased. Postintervention patients were more likely to transition home compared with another facility. CONCLUSIONS: Results support IDRs as a mechanism to improve time to PC referral, decrease LOS, direct cost, and 30-day mortality among hospitalized adults. A more objective method of identifying patients with unmet PC needs may be warranted.