Assessing the financial impact of an inpatient acute palliative care unit in a tertiary care teaching hospital.

Background: Evidence suggests palliative care consult services yield cost improvements; few studies have examined the impact of an inpatient palliative care unit on hospital costs.

Objective: This study estimates the cost avoidance of a single hospital's acute palliative care unit (APCU), building upon previous studies (1) by limiting pre-APCU costs to two days pre-APCU transfer, thereby minimizing bias from higher-cost first days of admission, and (2) by not limiting the study to cancer patients or patients who died, thereby presenting more comprehensive APCU costs.

Design: This retrospective study compares direct costs of care on an APCU with costs pre-APCU transfer from general medical units, intensive care units (ICU), and the emergency department (ED), and compares the direct costs of APCU patients with those of control patients.

End-of-life decision making and emotional burden: placing family meetings in context.

Background: Helping families make end-of-life care decisions can be challenging for health care providers in an intensive care unit (ICU). Family meetings facilitated by palliative care consult services (PCCS) have been recommended and found effective for improving support for families in these difficult situations. These services can be improved with a deeper understanding of factors associated with emotional burden in the aftermath of end-of-life decision making.

Optimizing the success of a palliative care consult service: how to average over 110 consults per month.

The widespread need for palliative care has prompted the development of hospital-based palliative care consult services to provide a more interdisciplinary approach to managing advanced illness and end-of-life concerns. Establishing a successful consult service is a challenging task. This is a descriptive study of the development of a palliative care consult service (PCCS) within a non-profit, multi-hospital health system, and the five successful strategies used to optimize growth over the first five years.