The Joint Commission Issues New Quick Safety Advisory on Palliative Care for Seriously Ill Patients Visiting the ED

Patients who are seriously ill often turn to, or are inappropriately admitted to, already overburdened emergency departments (EDs) for care that may better be addressed by palliative care services. A new Quick Safety advisory from The Joint Commission, “Palliative care: Better care for seriously ill patients visiting the ED,” provides guidance to help hospitals provide the most appropriate care to palliative care patients.   

Palliative care can be provided “at any stage of a serious illness and is beneficial when provided along with treatments of curative or life-prolonging intent,” according to the National Consensus Project for Quality Palliative Care (NCP). Palliative care attends to the physical, functional, psychological, practical and spiritual aspects of a serious illness. It provides symptom management, offers caregiver support and coordinates the provision of care across settings.

“When seriously ill patients are unnecessarily admitted to the emergency department or hospitalized, they are potentially exposed to adverse events such as healthcare-associated infections as well as physical or psychological trauma resulting from the admission,” says Debbie Holzer, RN, MSN, CRRN, project director, Department of Standards and Survey Methods, The Joint Commission. “If a seriously ill patient desires to receive palliative care services it is important that services are provided in the most appropriate setting to meet the patient’s needs and to avoid preventable ED or hospital admissions. Palliative care is shown to improve quality of life for both patients and their families and therefore should be offered as an option to seriously ill patients.”

The Quick Safety advisory provides recommended safety actions for hospitals to help address the needs of seriously ill patients, including:

• Examine trends in ED usage as well as hospital admissions to determine if appropriate palliative care services could benefit patients instead.
• Collaborate with local healthcare organizations that offer palliative care programs or provide palliative care services or expertise. 
• Provide palliative care education to all healthcare staff who care for seriously ill patients.
• Support efforts within EDs to incorporate palliative care principles into their practices. 

The advisory also includes resources from the NCP, National Hospice and Palliative Care Organization, and Center to Advance Palliative Care.