title: Characteristics of emergency department patients who receive a palliative care consultation.
abstract: BACKGROUND
  A large gap exists between the practice of emergency medicine and palliative care. Although hospice and palliative medicine has recently been recognized as a subspecialty of emergency medicine, few palliative care teams routinely interact with emergency providers, and primary palliative care skills among emergency providers are lacking.
  
  
  OBJECTIVE
  To identify the proportion and characteristics of patients who receive a palliative care consultation and arrive via the emergency department (ED).
  
  
  METHODS
  A descriptive study of adult ED patients from an urban, academic tertiary care hospital who received a palliative care consultation in January 2005 or January 2009.
  
  
  RESULTS
  In January 2005, 100 of the 161 consults (62%) arrived via the ED versus 63 of 124 consults (51%) in January 2009 (p=0.06). Mean days from admission to consultation in January 2005 were six days (standard deviation 11), versus nine days (SD 26) in January 2009 (p=0.35). Three of the 100 consultations (3%) in January 2005 were initiated in the ED, versus 4 of the 64 (6%) in January 2009.
  
  
  CONCLUSIONS
  At an urban academic medical center with a well-developed palliative care service, the majority of palliative care consultations were for patients who arrive via the ED. Despite this, only a small minority of consultations originated from emergency providers and consultation was on average initiated days into a patient's hospital stay.
authors.affiliation: Department of Emergency Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. corita.grudzen@mssm.edu
authors.forename: Corita R
authors.initials: CR
authors.lastname: Grudzen
authors.forename: Ula
authors.initials: U
authors.lastname: Hwang
authors.forename: Jason A
authors.initials: JA
authors.lastname: Cohen
authors.forename: Michael
authors.initials: M
authors.lastname: Fischman
authors.forename: R Sean
authors.initials: RS
authors.lastname: Morrison
mesh_terms: D016223:Advance Directives; D000368:Aged; D016009:Chi-Square Distribution; D004282:Documentation; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006305:Health Status Indicators; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010146:Pain / Q000188:drug therapy / Q000523:psychology*; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D012017:Referral and Consultation; D013223:Statistics as Topic; D013997:Time Factors