Expanding into the Emergency Department: Exploring Primary Palliative Care Initiatives Versus Embedded Palliative Care Programs (FR205)

Outcomes 1. Discuss the current evidence on program development within the intersection of palliative care and emergency medicine 2. Identify and categorize current implemented programs and strategies to support the needs of hospice and palliative medicine patients in the emergency department 3. Synthesize the pros and cons of a primary palliative care initiative in the emergency department (ED) versus an embedded palliative care program when expanding palliative care services into the ED Patients with serious illness often encounter fragmented care, challenges with coordination of services, and difficult-to-manage symptoms. The emergency department (ED) often serves as the safety net for patients with these problems, and thus these visits serve as an opportunity to address unmet palliative care needs. It is for these reasons that attention has turned to EDs to provide this care and develop solutions to expertly address patients’ upstream palliative care needs. During this session, we will discuss the current evidence on program development within the intersection of palliative care and emergency medicine. We will then review and categorize developing and established emergency medicine–hospice and palliative medicine (EM-HPM) programs and will focus on two common approaches: delivering education on primary palliative care skills to emergency providers and embedding specialized palliative care providers within the ED. We will present current programs that represent both of these approaches in detail, discuss outcomes and benefits, and culminate with a moderated question-and-answer session to further address the pros and cons of each of these approaches. Attendees will gain a better understanding of which EM-HPM initiatives have proven to be successful within the ED, hear best practices and lessons learned, and leave with strategies to help start similar programs in their own institutions.