Improving Access to Inpatient Hospice: Implementation and Impact of a Dedicated Comfort Care Service in a Tertiary Care Hospital.

Abstract

Hospice is the gold standard for end-of-life care. Many hospitalized patients on comfort care (CC) have a high symptom burden and qualify for General Inpatient Hospice (GIP) care. At our institution, many hospitalized patients who qualified for GIP were unable to discharge to stand-alone hospice facilities due to clinical instability or lack of beds. Prior attempts at providing GIP hospice in the hospital were unsuccessful. In July 2022, we created the General Medicine 24 (GM24) Comfort Care and Hospice Team to improve access to high-quality hospice services for hospitalized CC patients. We compared the number of patients receiving GIP care in the hospital and the number of CC patients discharged with hospice services before and after GM24 was created. In the three years since the creation of GM24, GIP admissions have increased annually, now 107% higher compared to the year before GM24 was created. Discharges to stand-alone inpatient hospice facilities have increased by 65% in the three years since GM24 was created compared to the year before GM24 was created. GM24 is a model that can be replicated to improve access to hospice care for hospitalized patients.