Review of a Study on Late Referral to a Palliative Care Consultation Service: Length of Stay and In-Hospital Mortality Outcomes

Author's disclosures of potential conflicts of interest are found at the end of this article. ® Review of "Late referral to palliative care consultation service: Length of stay and in-hospital mortality out-comes" by Humphreys & Harman A ccording to the National Consensus Project, pal-liative care is defined as " patient/family-centered care that optimizes quality of life by anticipating, preventing, minimizing, and treating suffering. Palliative care, offered throughout the continuum of illness, involves addressing physical, intellectual, emotional, social, and spiritual needs and to facilitate patient autonomy, access to information, and choice " (National Consensus Project, 2013). Palliative care is typically offered as an interdisciplinary team approach including physicians, nurses, social workers, chaplains, and specialists in other disciplines to manage pain and symptoms. The Institute of Medicine report " Dying in America " on the quality of care in the United States and its implications for the field of palliative care suggests there is a need to provide palliative care to oncology patients, specifically introducing the concept earlier in the disease trajectory Unfortunately, palliative care is often only offered late in the course of disease after curative measures have been exhausted. This concern of late referral to palliative care consultation is one that plagues many inpatient and outpatient palliative care consultative teams, often leading to suboptimal pain and symptom management, increased suffering, failure to discuss or adhere to advance care planning, and unplanned hospital deaths (Fischer et al., 2006; Teno et al., 2013). However, rather than encouraging a more integrated approach combining palliative care with life-prolonging therapy for patients with serious, advanced illness, current medical care often follows a