Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;60(3):e12-e16.
doi: 10.1016/j.jpainsymman.2020.06.009. Epub 2020 Jun 13.

The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis

Daniel Shalev  1 , Shunichi Nakagawa  2 , Oliver M Stroeh  3 , Melissa R Arbuckle  3 , Rebecca Rendleman  4 , Craig D Blinderman  2 , Peter A Shapiro  3
Affiliations

The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis

Daniel Shalev et al. J Pain Symptom Manage. 2020 Sep.

Abstract

Context: During the course of March and April 2020, New York City experienced a surge of a 170,000 coronavirus disease 2019 (COVID-19) cases, overwhelming hospital systems and leading to an unprecedented need for palliative care services.

Objectives: To present a model for rapid palliative care workforce expansion under crisis conditions, using supervised advanced psychiatry trainees to provide primary palliative services in the acute care and emergency setting.

Methods: In response to the New York City COVID-19 surge, advanced psychiatry trainees at New York-Presbyterian Columbia University Irving Medical Center were rapidly trained and redeployed to a newly formed psychiatry-palliative care liaison team. Under the supervision of consultation-liaison psychiatrists (who also served as team coordinators), these trainees provided circumscribed palliative care services to patients and/or their families, including goals-of-care discussions and psychosocial support. Palliative care attendings remained available to all team members for more advanced and specialized supervision.

Results: The psychiatry-palliative care liaison team effectively provided palliative care services during the early phase and peak of New York City's COVID-19 crisis, managing up to 16 new cases per day and provided longitudinal follow-up, thereby enabling palliative care specialists to focus on providing services requiring specialist-level palliative care expertise.

Conclusion: By training and supervising psychiatrists and advanced psychiatry trainees in specific palliative care roles, palliative care teams could more effectively meet markedly increased service needs of varying complexity during the COVID-19 crisis. As new geographic regions experience possible COVID-19 surges in the coming months, this may serve as a model for rapidly increasing palliative care workforce.

Keywords: COVID-19; primary palliative care; psychiatry; workforce.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Psychiatry-palliative care liaison team. ED = emergency department; CL = consultation-liaison.
See this image and copyright information in PMC

References

    1. Coronavirus. https://www.who.int/westernpacific/health-topics/coronavirus Available from.
    1. COVID-19: data—NYC health. https://www1.nyc.gov/site/doh/covid/covid-19-data.page Available from.
    1. Fausto J., Hirano L., Lam D. Creating a palliative care inpatient response plan for COVID-19—the UW medicine experience. J Pain Symptom Manage. 2020;60 e21-e26. - PMC - PubMed
    1. Vergano M., Bertolini G., Giannini A. Clinical ethics recommendations for the allocation of intensive care treatments in exceptional, resource-limited circumstances: the Italian perspective during the COVID-19 epidemic. Crit Care. 2020;24:165. - PMC - PubMed
    1. Flores S., Gavin N., Romney M.-L. COVID-19: New York City pandemic notes from the first 30 days. Am J Emerg Med. 2020 doi: 10.1016/j.ajem.2020.04.056. - DOI - PMC - PubMed

MeSH terms