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Development and implementation of an inpatient acute palliative care service
Santa-Emma PH, Roach R, Gill MA, Spayde P, Taylor RM.. Journal of palliative medicine, 2002-02-01
Topic: Risk, prevention and care in population studies
Context Although hospice programs are a well-established feature of the American medical system, inpatient palliative care services are a recent development. Therefore limited data about inpatient palliative care services has been published, and no large series has yet been reported. Objective To describe the development and implementation, as well as the characteristics and effectiveness, of a large inpatient acute palliative care service (APCS). Design, setting, and participants Data on patient demographics, diagnoses, key symptoms, and outcome were collected on each of the 3,712 patients seen from March 1997 to December 2000 by the APCS in a midwestern urban-suburban three-hospital system. Summary statistics were calculated and analyzed. Main outcome measures APCS intervention, most common symptoms, and diagnoses, survival, and discharge destination. Results Of the 3,712 patients seen by the APCS, 56.9% were transferred to the acute palliative care units (APCU) from elsewhere in the hospital, 16.3% were directly admitted to the APCU, and 26.9% were seen in consultation by the APCS without transfer to the APCU. The most common symptoms were dyspnea (53.9%), weakness (42.5%), and pain (40.8%); 88.7% of patients had one to three symptoms. The most frequent diagnoses were cancer (41.3%), cardiac disease (17.4%), pulmonary disease (14.0%), and stroke (9.4%). Of all patients seen by the APCS, 49.5% survived to discharge, although patients whose primary diagnosis was cancer or dementia had significantly higher discharge rates (64.7% and 59.6% respectively, p < 0.001). Of those discharged, 72.0% went home or to an extended care (ECF) with hospice, 13.8% went to an facility ECF without hospice, and 14.2% went home with other home care services. Conclusion Mount Carmel Health has developed an APCS and APCU integrated into the mainstream of each of its hospitals, providing an opportunity for a more appropriate focus on end-of-life issues for patients with poor prognoses, intense medical needs, and complex family issues.
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APA 7th
Santa-Emma, P. H., Roach, R., Gill, M. A., Spayde, P., & Taylor, R. M. (2002). Development and implementation of an inpatient acute palliative care service. Journal of palliative medicine. https://doi.org/10.1089/10966210252785051
Vancouver
Santa-Emma PH, Roach R, Gill MA, Spayde P, Taylor RM. Development and implementation of an inpatient acute palliative care service. Journal of palliative medicine. 2002. doi:10.1089/10966210252785051. PMID: 11839231.
BibTeX
@article{santaemma2002-11839231,
author = {Santa-Emma, P. H. and Roach, R. and Gill, M. A. and Spayde, P. and Taylor, R. M.},
title = {{Development and implementation of an inpatient acute palliative care service}},
journal = {Journal of palliative medicine},
year = {2002},
doi = {10.1089/10966210252785051},
pmid = {11839231},
url = {https://doi.org/10.1089/10966210252785051}
}
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Key findings
- Results Of the 3,712 patients seen by the APCS, 56.9% were transferred to the acute palliative care units (APCU) from elsewhere in the hospital, 16.3% were directly admitted to the APCU, and 26.9% were seen in consultation by the APCS without transfer to the APCU.
- Of all patients seen by the APCS, 49.5% survived to discharge, although patients whose primary diagnosis was cancer or dementia had significantly higher discharge rates (64.7% and 59.6% respectively, p < 0.001).
Study details
- Participants3,712
- Effect size56.9%; 16.3%; 26.9%
- Evidence strengthLow
How this study scored 50/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 29 of the 58 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of palliative medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2002 — older than 20 years, still counted |
| Sample size | 3 / 4 | 3,712 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11839231) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 29 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 29 of the 58 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
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