Project: The Effect of Expanding the Palliative Care Consult Team on Location of Death in a Veterans Affairs Medical Center Team:Washington DC Veterans Affairs Medical Center : Raya Kheirbek , MD ; Karen Blackstone,, MD; C. Conforti, Elizabeth Cobbs, MD; Joy Laramie , NP Contact: Karen.blackstone@med.va.gov Aims: To measure the effect of expansion of a Palliative Care Consult Team (PCCT) on yearly trends of place of death. Intervention: The role of the PCCT was expanded in 2002 The team identified hospitalized veterans with severe chronic illness that may benefit from palliative care interventions. When appropriate, assistance was provided to transfer care from the hospital to the nursing home, hospice/palliative care unit, or home with community hospice care. Results:   FY ’01 (before PCCT) FY ’02 (after PCCT) FY ’03 (after PCCT) No. of medical center deaths 353 288 279 MICU/SICU, No. (%) 99 (28%) 81 (28%) 78 (28%) Acute care, No. (%) 138 (39%) 86 (30%) 81 (29%) Nursing home, No. (%) 116 (33%) 121 (42%) 120 (43%) Community Hospice referrals 4 12 32 Between FY ’01-03, 920 veterans died while in medical center Prior to PCCT expansion, 2/3 of all deaths occurred in hospital After 1 st year of PCCT expansion, the % of deaths in acute care decreased by 27%, and by 30% for nursing home deaths. Conclusion: Expanded palliative care services in this VA medical center were associated with a shift in location of inpatient deaths from the acute hospital to the nursing home and increased utilization of community hospice, consistent with veteran/family wishes for care at the end of life.   <top> << Back to QIC Project Index