Emergency physicians face no shortage of tasks and responsibilities when it comes to stabilizing injured or seriously ill patients. But now momentum is building to better integrate palliative care into the emergency setting.
Studies suggest that doing so can help boost the patient’s quality of life, improve outcomes, reduce length-of-stay, enhance patient and family satisfaction, and cut costs.1 Realizing these benefits means physicians must find ways to carve out time amid the crowded and often-chaotic conditions of the emergency room. Payment policies, too, must be developed to reimburse physicians for their palliative care contributions.2
Yet perhaps the greatest barrier to increased adoption of palliative protocols is widespread confusion surrounding what the subspecialty actually is. Despite assumptions to the contrary, palliative and hospice care are not the same.
Hospice care involves treatments aimed at easing the end-of-life experience. Palliative care, in contrast, focuses on reducing the pain, symptoms and stress surrounding serious illness, regardless of the diagnosis. Typically, this process begins with discussions between the physician and patient and/or family regarding the patient’s goals, concerns and desires.
In essence, palliative care encompasses strategies and interventions aimed at improving the quality of life for physically unstable patients; patients who have previously visited the ED for the same condition in the last few months; have difficult-to-manage symptoms; experience weight loss, loss of appetite or decline in function; or have long-term, complex care needs, according to an article in produced by the Society of Critical Care Medicine.3
Because of the role emergency physicians frequently play in providing initial care, they’re uniquely positioned to support palliative care interventions early in a patient’s disease trajectory. This involvement can mean not only a better quality of life but decreased utilization of intensive care and associated cost savings, according to the American College of Emergency Physicians (ACEP).
“There is a growing body of literature focusing on palliative care in the ED and numerous champions of this subspecialty emerging in hospitals of all sizes,” the ACEP wrote. “Future research and collaboration within the ED community needs to be a priority to set the standards and policies in support of these vulnerable patients.”4
To learn more about the nexus between emergency medicine and palliative care, visit: