A palliative training program for emergency department staff in 29 hospitals did not reduce hospital admissions, a recent study found.
Researchers examined the results of the PRIM-ER trial, a cluster randomized clinical trial that took place in close to 30 hospitals nationwide. Through PRIM-ER, emergency department clinicians received training in palliative care, simulation-based communication workshops, clinical decision support tools and audit and feedback.
“This multicomponent intervention to initiate palliative care in the ED did not have an effect on hospital admission, subsequent health care use, or short-term mortality in older adults with serious, life-limiting illness,” the researchers concluded.
Researchers evaluated the initial emergency department visits of nearly 99,000 seniors with serious illnesses before and after implementation of PRIM-ER. The study did not measure access to palliative care as an outcome. The results were published in JAMA.
The PRIM-ER interventions took place between 2018 and 2022, meaning that the results could have been influenced by the COVID-19 pandemic.
Prior research has touted the effectiveness of palliative care consults in the ED.
Health systems can realize a 6.7% return on investment by embedding palliative care clinicians in the ED, a 2023 study published in the Journal of Palliative Medicine found. The researchers, from San Diego-based Scripps Health, also found that palliative consults increased 10x in the ED, contributing to increased hospice and palliative care clinic referrals.
A second 2023 study, done at Rush University Medical Center in Chicago, found that an embedded palliative practitioner increased consults by 591% over the course of one year, resulting in a more than 50% reduction in median hospital lengths of stay.
