Many seriously ill patients receive intensive, surgical, and emergency treatments in the final months of their lives despite their wishes to avoid aggressive care. One key strategy for improving serious illness care is to engage specialist palliative care clinicians in the management of patients who are admitted to hospitals. However, clinicians' difficulties identifying patients who need specialty palliative care sometimes leads to inefficient and inequitable care. To mitigate this challenge, many health care systems have implemented triggers (set criteria) to facilitate patient identification; yet, the acceptability of triggering palliative consults has not yet been explored. Leveraging the existing research structure of the ongoing Palliative Connect project at the University of Pennsylvania Health System (UPHS), the research team will conduct semi-structured interviews with patients who received a triggered palliative care consult as part of the Palliative Connect study; any hospitalist attending physician who cared for a patient at the time of the triggered consult; and any clinician member of the UPHS Palliative and Hospice Medicine program. Insights from this study will identify patient and caregiver, hospitalist physician, and palliative care specialist preferences and perceptions regarding triggered specialty palliative care for seriously ill hospitalized patients. The research team will also look at diagnosis and demographic characteristics to understand whether rates and reasons of cancelling triggered consultations differ among groups.
Penn Patient-Centered Outcomes Research Pilot Program