Background: Although Hospice has been associated with improved symptom management, quality of life, lower costs and length of survival in terminally ill patients, it is underutilized. The primary outcome of this study was to examine the relationship between hospice enrollment status and hospital readmissions in elderly patients with solid tumors. Secondary outcomes were length of [...]

Background: Advance Care Planning (ACP), palliative care (PC), and enrolling inpatients near end of life into hospice are known methods to improve patient experience and reduce inappropriate use of inpatient (IP) resources. We sought to increase ACP, PC, and hospice referral by proactively identifying patients near end of life. Methods: In 2020 we introduced the [...]

Background: Background: Essentia Health St Mary’s Medical Center, a tertiary referral center serving the rural areas of Northeastern Minnesota and Northwestern Wisconsin, identified disparities in hospice utilization of Medical Shared Savings Programs (MSSP) decedents in 2021 – 2022 (40% vs 53% Medicare national, 2nd quarter 2022). Health system metrics on hospital readmission and length of [...]

Background: Although the vast majority of adult patients in the United States prefer to die at home, most patients die in acute care settings. Barriers include advanced care planning, communication between inpatient and outpatient providers, and delivery of medical equipment. In 2018, our General Medicine Service Line ranked 73rd out of 98 Academic Medical Centers [...]

Case Presentation: A 70 year old female with metastatic cholangiocarcinoma, heart failure with reduced ejection fraction, stage 4 chronic kidney disease and pulmonary embolism on anticoagulation presented to a NYC safety net hospital with bilateral lower extremity edema, dyspnea at rest and a recent unwitnessed fall. Her malignancy was diagnosed 7 months prior and her [...]

Background: In Texas, the five-year survival rate for lung cancer is significantly lower compared to the national average with noted disparities in early diagnosis and treatment. The aim of this study is to assess sex, ethnic and racial differences in end-of-life healthcare utilization, advance care planning (ACP) and associated outcomes such as hospice use among [...]

Case Presentation: 71M with PMHx of pAfib on Eliquis, HTN, and CKD3a admitted to MICU as transfer for AHRF with severe pulmonary HTN s/p intubation, pressor support, NGT placement during planned TEE cardioversion for persistent Afib. On arrival active upper GIB was present through his NGT and emergent EGD revealed large distal esophageal mass; cytology [...]

Case Presentation: 85-year-old male with a history of hypertension, hyperlipidemia, coronary artery disease, and advanced dementia presented to the hospital with altered mental status and right-sided weakness and, was found to have left-sided acute on chronic subdural hematoma of the left frontal lobe and underwent a craniotomy and clot evacuation surgery. During the hospitalization, the [...]

Case Presentation: 82-year-old female with atrial fibrillation, non-ischemic cardiomyopathy (EF 25%), rheumatoid arthritis, bed bound at home with hospice care presents for acute encephalopathy and tachycardia. Patient’s son (the primary caregiver) reported that patient is on four drops of oral 1% atropine solution daily for bronchorrhea. Accidentally a family member who is not a primary [...]