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. 2018 Aug;35(8):1057-1062.
doi: 10.1177/1049909117751878. Epub 2018 Jan 11.

Five-Year Experience of an Inpatient Palliative Care Unit at an Academic Referral Center

Myrick C Shinall Jr  1 , Sara F Martin  1 , Jill Nelson  1 , Richard S Miller  2 , Matthew W Semler  3 , Eli E Zimmerman  4 , Christy C Noblit  3 , E Wesley Ely  3   5 , Mohana Karlekar  1
Affiliations

Five-Year Experience of an Inpatient Palliative Care Unit at an Academic Referral Center

Myrick C Shinall Jr et al. Am J Hosp Palliat Care. 2018 Aug.

Abstract

Background: Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center.

Methods: We retrospectively reviewed a prospectively collected database of all admissions to the PCU at Vanderbilt University Medical Center in the first 5 years of its existence, from 2012 through 2017.

Results: Over these 5 years, there were 3321 admissions to the PCU. No single underlying disease process accounted for the majority of the patients, but the largest single category of patients were those with malignancy, who accounted for 38% of admissions. Transfers from the intensive care unit accounted for 50% of admissions, with 43% of admissions from a hospital floor and 7% coming from the emergency department or a clinic. Median length of stay in the PCU was 3 days. In hospital deaths occurred for 50% of admitted patients, while 38% of patients were discharged from the PCU to hospice.

Conclusion: These data show that a successful PCU is enabled by buy in from a wide variety of referring specialists and by a multidisciplinary palliative care team focused on care of the actively dying patient as well as pain and symptom management, advance care planning, and hospice referral since a large proportion of referred patients do not die in house.

Keywords: hospice; length of stay; outcome evaluation; palliative care consultation; palliative care unit; terminal care.

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Figures

Figure 1
Figure 1
Primary Life Limiting Diagnoses for Patients Admitted to Palliative Care Unit
Figure 2
Figure 2
Primary Services From Which Palliative Care Unit Patients Are Transferred
Figure 3
Figure 3
Routes of Admission to the Vanderbilt PCU
See this image and copyright information in PMC

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