Standardized Palliative Care Consults Cut Readmissions 18% Among Some Cancer Patients

By Jennifer Thew, RN

Palliative care in very sick patients can reduce their distress and that of caregivers and decrease unwanted healthcare use. Yet some patients are not offered palliative care.

Standardizing the criteria that trigger palliative care consultations for patients with advanced cancers may help. Standardization has been shown to improve quality of care and reduce 30-day readmissions, according to a study published in The Journal of Oncology Practice.

Patients on an inpatient solid tumor service received an “automatic” palliative care consultation when they met at least one of the following four criteria, or “triggers:”

  • Had an advanced solid tumor
  • Prior hospitalization within 30 days
  • Hospitalization greater than seven days
  • Active symptoms

Patients who met the criteria and triggered an automatic consultation received palliative care consultations 80% of the time vs. 39% among control subjects. Hospice referrals were greater among the intervention group (26%) compared to the control group (14%).

“Patients with advanced cancer admitted to an acute care hospital often have short life expectancies and high morbidity,” said the study’s lead author Kerin Adelson, MD, assistant professor of medical oncology at Yale Cancer Center and Chief Quality Officer and Deputy Chief Medical Officer for Smilow Cancer Hospital in media release.

“For these patients, the integration of palliative care has improved symptom burden, reduced patient and caregiver distress, increased referral to hospice, and improved outcomes.”