The combination of increasing numbers of hospitalists and their growing responsibility for the care of patients at the end of life (EOL) requires hospitalists to have palliative care skills. Although previous surveys have documented the desire for more palliative care training, no study has evaluated a cohort of hospitalists' experiences with and confidence to provide key aspects of palliative care.
Based on evaluation tools accessed online from the End of Life Physician Education Resource Center (EPERC), we developed a survey to assess hospitalists' experience providing EOL care and to quantify their self‐assessed confidence in providing and teaching about palliative care. It also included a 40‐question test to assess baseline knowledge in a number of palliative medicine competencies. We invited hospitalists actively engaged in direct care of patients at an urban academic medical center to anonymously complete the 30‐minute survey via an online survey tool.
Of the 31 hospitalists invited to participate, 23 (74%) completed the survey. Eighty‐three percent of the hospitalists had cared for at least 1 patient who died in the hospital within the previous 6 months. The majority reported frequent (at least weekly) management of both cancer and noncancer pain and frequent EOL discussions, including conversations about code status, prognosis, and breaking bad news. Yet, only 34.8% agreed with the statement “I have received enough training to provide competent end‐of‐life care.” Although most respondents had received some palliative care training in the form of lectures, only 30.4% had any experiential training in palliative care. With the exception of giving bad news, discussing DNR orders, and treating constipation, comfort with many palliative care competencies was lacking among many respondents. For the most part, participants felt even less well prepared to teach many key tasks (see Table 1). Assessment of their palliative care knowledge also uncovered important deficits, with a pretest mean score of 67,3% ± 9.6%.
This survey reveals a mismatch between amount of EOL care provided by hospitalists and the confidence necessary to perform key palliative care competencies. Though this study is limited by its small sample size from a single institution, it suggests that more extensive needs assessment and effective palliative care training are needed for hospitalists.
E. Szmuilowicz, none; A. Ogunseitan, none; M. Williams, none.
To cite this abstract:Szmuilowicz E, Ogunseitan A, Williams M. A Survey of Hospitalists' Experience with Palliative Care. Abstract published at Hospital Medicine 2009, May 14-17, Chicago, Ill. Abstract 97. Journal of Hospital Medicine. 2009; 4 (suppl 1). https://www.shmabstracts.com/abstract/a-survey-of-hospitalists-experience-with-palliative-care/. Accessed April 8, 2020.