Wednesday, March 2, 2016

Palliative Care in the ED

emDocs - March 2, 2016 - 
Authors: Schnittke N and Van Vliet H
Edited by: Singh M and Koyfman A
"The role of palliative medicine in emergency care has received increasing attention since ACEP’s decision in February of 2013 to join the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely ® initiative. In an effort to maintain (and potentially improve) quality of care while reducing costs, ACEP identified discussions regarding hospice and palliative medicine (HPM) as one of ten opportunities for ED providers and their patients to eliminate low-yield and possibly harmful testing and treatments. The explicit directive is “Don’t delay engaging available palliative and hospice care services in the emergency department for patients likely to benefit.” A number of resources have been developed to aid ED providers with such efforts. These include the Improving Palliative Medicine in Emergency Medicine (IPAL-EM) project through the Center to Advance Palliative Care (CAPC) and the Education in Palliative and End-of-life Care for Emergency Medicine (EPEC®-EM) curriculum. Of note, EM residency trained physicians are eligible to complete many HPM fellowships and may subsequently obtain HPM board certification. However, gaining such a high-level of expertise is not necessary. The following discussion addresses how simple, fundamental skills in HPM can significantly enhance your practice in emergency medicine."