Experience with an end-of-life practice at a university hospital

Objective: To describe a 10-yr experience with an end-of-life practice in a hospital. Design: A nonexperimental, prospective, descriptive design was used to record variables from a convenience sample of patients transferred to the Comprehensive Supportive Care Team. Setting: Detroit Receiving Hospital is an urban, university-affiliated, Level I trauma/emergency hospital. Patients: Patients who are not expected to survive hospitalization, and for whom a decision has been made to focus care on palliative interventions, are candidates for care by this practice. Interventions: None. Measurements and Main Results: Patient demographics, including the following information: age; gender; diagnoses; illness severity; mortality rate; and disposition. Measures of resource utilization included: referral sources; Therapeutic Intervention Scoring System values; bed costs; and length of hospital stay. Satisfactory patient/family care with a measurable reduction in the use of resources can be achieved in the hospital setting. Conclusions: A hands-on approach to the care of dying patients by this specialty, palliative care service has provided patients, families, and clinicians with the type of support needed for satisfactory end-of-life care. A summary of our experience may be useful to others.