Improving Access to Inpatient Hospice: Implementation and Impact of a Dedicated Comfort Care Service in a Tertiary Care Hospital

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BACKGROUND: Hospice is the gold standard for end-of-life care. Many hospitalized patients on comfort care (CC) have a high symptom burden and qualify for General Inpatient Hospice (GIP) care. LOCAL PROBLEM: At our institution, many hospitalized patients who qualified for GIP were unable to discharge to stand-alone hospice facilities due to clinical instability or lack of beds. Prior attempts at providing GIP hospice in the hospital were unsuccessful. INTERVENTIONS: In July 2022, we created the General Medicine 24 (GM24) Comfort Care and Hospice Team to improve access to high-quality hospice services for hospitalized CC patients. METHODS: We compared the number of patients receiving GIP care in the hospital and the number of CC patients discharged with hospice services before and after GM24 was created. RESULTS: In the three years since the creation of GM24, GIP admissions have increased annually, now 107% higher compared to the year before GM24 was created. Discharges to stand-alone inpatient hospice facilities have increased by 65% in the three years since GM24 was created compared to the year before GM24 was created. CONCLUSIONS: GM24 is a model that can be replicated to improve access to hospice care for hospitalized patients.

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