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Learning Objective 1: Validate the effectiveness of Palliative Care Education in an Intensive care unit
Learning Objective 2: Improve the care for the elderly patients in ICU by reducing prolonged length of stay (LOS)through implementation of palliative Care Services
Education: Case Western Reserve University, School of Nursing/Huron Hospital
Current Position: Director, Huron Palliative Care Services
Principal Area of Research Interest: Educate Palliative Care to Health Care Providers & the Community
Current Research Support: Aetna Educational Fund
Financial Impact of Palliative Services at Huron Hospital (FIPS-Huron)
A Chideme-Munodawafa, K Ravakhah, JW Yoo
Huron Hospital, a Cleveland Clinic hospital, Cleveland, Ohio
Study: Palliative medicine is the discipline of medicine where clinical as well as social, cultural and holistic approach meet. However, the financial impact of palliative medicine is not clear. By educating healthcare providers as well as the community served by Huron Hospital, especially the frail elderly, we may be able to reduce costs associated with hospitalization that arise from prolonged LOS and futile procedures in ICU. We studied the financial aspect of patient care in ICU following the establishment of palliative care services and formal residents' rotation.
Methods: A retrospective, longitudinal descriptive method was used. Inclusion criteria were age 65 years older, admission to ICU, and co-morbidities numbering 5 or more by ICD-9. The main outcome was total costs and LOS. A total of 1,769 patients were enrolled. Periods were divided into three groups: Pre-educational Era(PE: August 2004 to July 2005), Transitional Era with no involvement of residents(TE: August 2005 to June 2006), and Educational Era with palliative care residnets involvement (EE: July 2006 to May 2007).
Results: There were significant differences of costs , p< .011 (US 10,000$) and LOS , p< .046 (1.36 days) between (TE and EE) and (PE and EE). There was no statistical significance of age and the mortality rate.
Conclusion: The introduction and establishment of formal pallitive care services and medical residents rotation improved financial impact and shortened LOS of the critically ill elderly patients admitted to Huron Hospital ICU. The mortality rate remained unchanged.
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