title: [Emergency department as final destination: perception and reception of the palliative patient" concept as well as approach toward improving interdisciplinary collaboration - a survey of emergency personnel of a Swiss emergency department].
abstract: BACKGROUND
  As the demand for palliative care (PC) in emergency wards continues to increase, emergency medicine is increasingly focusing on the care of extremely ill patients with incurable, chronic and/or advanced diseases. There is no consistent definition of the profile of PC or understanding of what PC involves. The mistake is often made of confusing PC with end-of-life or terminal care. The present study was intended to assess the situation at the Department of Emergency Medicine, Inselspital, Bern University Hospital (UNZ), which cares for about 32 400 patients annually. The plan was to find out how much staff members knew about PC and to survey their personal attitudes.
  
  
  METHODS
  The employees of the UNZ were surveyed with an online questionnaire by a special institution outside the hospital. This is based on an instrument [1] developed in a comparative study in an emergency ward in the USA and used for physicians.
  
  
  RESULTS
  60 of 154 staff members (physicians and nurses) completed the questionnaire, corresponding to a response rate of 39%. The definition of palliative care (n=60) was very mixed and could be classified into 6 areas. In response to questions about specific services, the staff members mentioned that their access to existing patient data should be facilitated. They also expressed the wish for a 24 h palliative consultation service and thought that, during normal working days, more time should be allotted to discussing issues related to palliative care.
  
  
  CONCLUSIONS
  It has been confirmed that the definition of palliative care is not consistent. Within the UNZ, there is no clear procedure, but lack of time for detailed discussions with patients needing palliative care. Patient wishes or living wills with the DNR/DNI procedure do not contradict the personal ethics of most staff members. UNZ staff members would welcome the 24 h availability of a specialized PC team, as well as the development of guidelines and increased training in PC.
authors.affiliation: Universitäres Notfallzentrum, Departement Intensivmedizin, Notfallmedizin und Anästhesiologie, Inselspital, Universitätsspital Bern.
authors.forename: Laurence
authors.initials: L
authors.lastname: Klenk
authors.affiliation: Universitäres Notfallzentrum, Departement Intensivmedizin, Notfallmedizin und Anästhesiologie, Inselspital, Universitätsspital Bern.
authors.forename: Nicoletta M
authors.initials: NM
authors.lastname: Iucolano
authors.affiliation: Universitäres Notfallzentrum, Departement Intensivmedizin, Notfallmedizin und Anästhesiologie, Inselspital, Universitätsspital Bern.
authors.forename: Christian Tasso
authors.initials: CT
authors.lastname: Braun
authors.affiliation: Universitäres Notfallzentrum, Departement Intensivmedizin, Notfallmedizin und Anästhesiologie, Inselspital, Universitätsspital Bern.
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
authors.affiliation: Zentrum für Palliative Care, Inselspital, Universitätsspital Bern.
authors.forename: Steffen
authors.initials: S
authors.lastname: Eychmüller
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D003625:Data Collection; D004636:Emergency Service, Hospital; D006801:Humans; D033183:Interdisciplinary Communication; D010166:Palliative Care; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013557:Switzerland
keywords: Notfallmedizin; Palliative Care; emergency medicine; médecine d'urgence; palliative care; soins palliatifs