title: The impact of a palliative care program in a rural Appalachian community hospital: a quality improvement process.
abstract: BACKGROUND
  Hospital inpatient palliative care consultation services (PCCSs) provide high-quality, comprehensive care for seriously ill patients and their families. The objective of the Palliative Care Impact Study was to evaluate the impact of a PCCS in a rural Appalachian community hospital in 4 domains: clinical, customer, operational, and financial.
  
  
  RESULTS
  A nonrandomized preintervention-postintervention study enrolled 25 patients. We collected data in the 4 domains listed above after a palliative care (PC) consultation and compared them with preconsultation data. Findings demonstrated a statistically significant improvement in pain and symptom burden scores; customer metrics produced an excellent rating of 88.5% by patients and families and physician/providers; with an associated cost savings of $521 per patient per day after PC consultation was complete.
authors.affiliation: Pikeville Medical Center, Pikeville, KY 41501, USA. bernita.armstrong@pikevillehospital.org
authors.forename: Bernita
authors.initials: B
authors.lastname: Armstrong
authors.forename: Bharat
authors.initials: B
authors.lastname: Jenigiri
authors.forename: Sadie P
authors.initials: SP
authors.lastname: Hutson
authors.forename: Peter M
authors.initials: PM
authors.lastname: Wachs
authors.forename: Camille Eckerd
authors.initials: CE
authors.lastname: Lambe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001061:Appalachian Region; D001291:Attitude of Health Personnel; D003147:Communication Disorders; D003363:Cost Control / Q000379:methods; D005260:Female; D006764:Hospitals, Community / Q000191:economics / Q000592:standards; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010166:Palliative Care / Q000191:economics / Q000592:standards*; D017060:Patient Satisfaction; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D058996:Quality Improvement / Q000458:organization & administration / Q000592:standards*; D019035:Rural Health Services / Q000191:economics / Q000592:standards; D018434:Sickness Impact Profile