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Care Planning for Inpatients Referred for Palliative Care Consultation

JAMA Intern Med. 2018;178(1):48-54. doi:10.1001/jamainternmed.2017.6313

Key Points

Question What are the characteristics of patients referred to inpatient palliative care (PC) consultation teams for advance care planning (ACP) or goals of care (GOC) discussions, what ACP/GOC needs are identified, and what are the outcomes?

Findings In this cohort study of 73 145 patients in inpatient palliative care teams, a need for ACP/GOC was the most common reason for inpatient PC consultation, and ACP/GOC needs were frequently identified even when the consultation request was for other reasons. During PC consultation, surrogates were identified and patients’ preferences regarding life-sustaining treatments were updated; however, only a minority of patients completed legal forms to document their preferences.

Meaning Inpatient PC consultation meets a common and important need, but there remains opportunity for improvement.

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