Emergency Department: Integrating Palliative Care
Patients and families living with serious illness who are seen in the Emergency Department (ED) may receive palliative care services via either 1) referral for consult by the palliative care team, and/or 2) delivery of palliative care services by trained ED staff. Ideally, these models occur in parallel.
This toolkit was developed and curated by the Advisory Board of IPAL-EM: Improving Palliative Care in Emergency Medicine in an effort to increase access to palliative care services for patients in the ED and their families.
What’s in the Toolkit
Assessing Need and Making the Case
The "what and why" of ED palliative care, including standards for ED palliative care and how to make the case.
Make the case to administrators for starting an ED-palliative care integration project. Includes data on gaps in 'usual' care and best practice recommendations.
THE IPAL-EM board has developed clinical practice guidelines for Emergency Department palliative care services, adapted from the National Consensus Project for Quality Palliative Care.
Used by emergency department and palliative care staff as a self-assessment tool to guide integration of palliative care services in the ED.
Kick-start an ED-palliative care integration project using a structured needs assessment.
A roadmap for planning and implementing a project to integrate palliative care principles into daily emergency department care.
Program Design
Practical guidance on model design and tools for identifying patients in the ED who would benefit from palliative care.
Presenter: Tammie E. Quest, MD. March 2015.
Screening tool to identify patients with unmet palliative care needs. For ED staff.
Guidance on program design and program operations for the pediatric palliative care program.
Sample Policies and Clinical Tools
Tools for both palliative care and ED teams to assess need, conduct family meetings about priorities for care, and provide services in the ED.
CAPC consensus report for identification of patients with palliative care need. 2011.
Screening tool to identify patients with unmet palliative care needs. For ED staff.
Key concepts for palliative care teams when providing consultations in the emergency department.
Opioid pocket reference for providers including safe starting doses, equianalgesic chart, and standard dosing strengths.
A stepwise approach for all members of the health care team for leading meetings with patients and caregivers.
For use by ED staff. Shared by Froedert Hospital, Medical College of Wisconsin.
For use by ED staff. Shared by Central Baptist Hospital.
Sample tool used for quality improvement in the ED. Shared by Emory University Hospital Midtown.
10-step guide including recommended phrases for the clinical team. Shared by Mount Sinai Hospital.
Quality Measurement Tools
Measurement strategies to evaluate patient, family, and clinician satisfaction with services, in support of ongoing quality improvement.
Consensus recommendations on key operational, clinical and satisfaction metrics that emergency departments can track to ensure quality palliative care services.
Use this toolkit to select program measures that demonstrate value and support quality care delivery. Overcome common measurement obstacles and synthesize program data.
NPCRC provides measurement and evaluation tools for research, including pain and symptom management, functional status, psychosocial care, caregiver assessment, and quality of life.
Clinical Training Resources
Train ED teams in communication skills and family caregiver support, including CAPC’s online CE curriculum on communication skills for clinicians from all disciplines.
Online training curriculum for all specialties and disciplines to strengthen their care of patients living with serious illness. Free continuing education credits for all, and physicians receive ABIM MOC credits for select courses.
Education in Palliative and End-of-life Care for Emergency Medicine (EPEC - Emergency Medicine) teaches essential clinical competencies in palliative care to professionals who work in the emergency department (ED).
A train-the-trainer program, held once or twice annually at a specific location, covering eight curriculum modules. Participants receive up-to-date resources for teaching at their home institutions.
Educating Social Workers in Palliative and End-of-Life Care (ESPEC) is an innovative training program designed for health social workers by social workers to promote the integration of primary palliative care skills into clinical practice.
Concise, practical, peer-reviewed, and evidence-based summaries on topics important to clinicians and trainees caring for seriously ill patients. Use Fast Facts to onboard staff and for ongoing team education.
Information for Patients and Families
Online information to explain the role and benefits of palliative care to patients and families.
Information for patients and families about palliative care.
Jargon-free information for families of patients who are at the end of life. Published by the National Insitute on Aging (NIA).
Reference Library and IPAL Advisory Council
Relevant publications for integrating palliative care in the Emergency Department.
Relevant literature for palliative care-ED integration.
Members of CAPC's IPAL-EM Advisory Council, which co-authored many of the resources in this toolkit.
