Characteristics of patients enrolled in hospice presenting to the emergency department

Characteristics of patients enrolled in hospice presenting to the emergency department 
American Journal of Emergency Medicine; by Kayla P Carpenter, Fernanda Bellolio, Cory Ingram, Aaron B Klassen, Sarayna S McGuire, Alisha A Morgan, Aidan F Mullan, Alexander D Ginsburg; 12/9/24, online ahead of print 
Emergency Departments (EDs) frequently care for patients with life-limiting illnesses, with nearly 1 in 5 patients enrolled in hospice presenting to an ED during their hospice enrollment. This study investigates the reasons patients enrolled in hospice seek care in the ED, the interventions they receive, and their outcomes. ... Patients enrolled in hospice most frequently presented to the ED for trauma [36%; with 15% for pain, 12% for catheter/tube malfunction]. Most received laboratory studies and imaging. Nearly half of patients were admitted to the hospital and short-term mortality was high, particularly for patients enrolled in hospice for <30 days, enrolled with a hospice diagnosis of cancer, or admitted to the hospital. Understanding the care patients enrolled in hospice receive in the ED can help prevent avoidable visits and ensure care aligns with patients' goals.
Editor's note: Compare this data to your hospice patients' ED visits (and associated hastened "short-term mortality") to assess strengths and gaps in your patient care. Will a QAPI project reduce patients' needs for ED care? For example:

• Strengthen your patients' falls prevention and caregiver education to reduce traumatic events.
• Improve pain assessments, timely delivery of medications, and caregiver education.
• Strengthen education about catheter/tube care for nurses, aides, and caregivers.

Ultimately, use this information to improve your patient care, reduce preventable ED visits that can also result in "shortened mortality," reduce costs, and prevent extreme stress for caregivers (including potentially more difficult grief from these traumatic events and hastened deaths).