Implementing a Standardized Workflow Process to Increase the Palliative Care to Hospice Admission Rate.

BACKGROUND
Palliative care is a precursor for hospice care, an underutilized Medicare benefit that has been shown to improve quality of life, decrease health care costs, and provide expert symptom relief at the end of life.


LOCAL PROBLEM
Palliative patients transitioning to hospice services were experiencing delays within the admission process.


PURPOSE
To determine whether standardizing the workflow process with chart completion leads to increases in the hospice admission rate for palliative care patients transitioning to hospice care.


METHODS
This quality improvement project adapted Kurt Lewin's change theory and the Plan-Do-Study-Act (PDSA) cycle for implementation. Preintervention patient data were collected from May 2021 through August 2021, and postintervention data were collected from September 2021 through December 2021.


INTERVENTIONS
Standardization of the workflow process included assigning an urgency level to the hospice referral and deactivation (close) of the electronic medical record (EMR) chart, signaling completion of the workflow process.


RESULTS
The palliative care to hospice admission rate increased by 11.5% in the postintervention group. The EMR chart deactivation rate increased by 55.3%, which was statistically significant (P ≤ .001).


CONCLUSIONS
The standardized workflow process increased the number of palliative care to hospice admissions and improved the effectiveness of transitioning palliative care patients to hospice services.