New initiative to integrate and increase use of palliative care in ED

New initiative will promote shift in care for seriously ill patients in the ED

A new national initiative, IPAL-EM (Improving Palliative Care in Emergency Medicine) will integrate and increase the use of palliative care when seriously ill patients are admitted to the emergency department.

Despite growing recognition of the role of the palliative care in emergency medicine, integration of the two can often seem like a challenge of cultures and mindset. Supported by the Center to Advance Palliative Care and the Olive Branch Foundation, the new initiative will focus on areas of common ground.

Developed by an interdisciplinary team of experts, IPAL-EM will support both emergency and palliative care professionals and will act as the central U.S. hub for shared expertise, evidence, tools and resources. The goal is to promote a paradigm shift in the way that seriously ill patients, and their families, are cared for in the emergency setting.

"The emergency department is an underappreciated but key site for patients and families to receive palliative care. Seriously ill patients often experience pain and other symptoms that require immediate evaluation, excellent communication and 24/7 treatment," said Tammie E. Quest, MD, Director of The IPAL-EM Project.

Palliative care is specialized medical care focused on relief from the symptoms, pain, and stress of a serious illness-whatever the diagnosis. It is appropriate at any age and at any stage in an illness and can be provided along with curative treatment. The goal is to improve quality of life for both the patient and the family.

"Every seriously ill hospitalized patient should have access to palliative care, and the emergency department is no exception. We expect to see an enormous positive impact on both patients and their families," said Diane E. Meier, MD, Director of the Center to Advance Palliative Care. "This is a pioneering project, and CAPC is thrilled to join with the Olive Branch Foundation in supporting it."

Emergency teams manage critical initial evaluations, initiate pain and symptom treatment, shepherd communication and ensure transitions to other care settings. Integration of palliative care is expected to improve control of physical symptoms and reduce family anxiety, depression and post‐traumatic stress disorder. Care plans are expected to become more realistic, appropriate and consistent with patients' preferences. Conflicts about the use of life‐sustaining treatments should be reduced, and patients are expected to experience earlier transitions to appropriate settings.

There are also benefits to the hospital, including reduced use of non‐beneficial treatments, reduced hospital length of stay, reduced readmissions to the hospital and improved patient safety and satisfaction with care.