Utilization of the No One Dies Alone Program to Support Dying Patients.

Abstract

The No One Dies Alone (NODA) program has utilized trained volunteers to provide support to dying patients for over 20 years. Evaluating program utilization at a large, urban medical center can provide insights to guide expansion and address unmet needs. We conducted a retrospective cohort study of hospitalized patients enrolled in the NODA program at Harborview Medical Center (HMC), a level I trauma center in Seattle, WA. The NODA program has been operating at HMC since 2012, and our cohort includes data through 2020. We extracted patient demographics, admission characteristics, and program utilization metrics from the electronic health record and used descriptive statistics to summarize the data from decedents. During the study period, 245 patients were referred to the NODA program, and data were available for 234 hospitalized patients. The average length of time spent in the program was four days (SD 6), with 37% of patients enrolled for only a single day. Most patients received a visit from NODA volunteers, although 22% had no volunteer visits. In cases where a volunteer did not visit, the most common reason was patient death prior to volunteer arrival (92%). Many patients had family visit during the hospitalization (56%). The NODA program was utilized for patients with and without family support. Some patients were unable to benefit from the program due to timing of referral relative to death, highlighting the importance of early consultation to maximize program benefits.