Implementation of an ad hoc hospital-based palliative care consult service.

Introduction Nearly 50% of Americans who die from chronic illness die in acute hospital settings, underscoring the critical need to better address the complex needs of terminally ill patients and their families in the acute care setting.1 A number of efforts have been undertaken to improve care for hospitalized terminally ill individuals.2–4 One approach is a palliative care consult service (PCCS). Studies indicate that PCCSs are effective in improving symptom control, facilitating understanding of diagnosis and prognosis, contributing to appropriate discharge disposition, changing patterns of care, and reducing resource utilization.5,6 PCCSs are also rich resources for teaching hospice and palliative medicine.7 The PCCS at the University of Colorado Hospital (UCH) arose from the desire of members of an interdisciplinary group of faculty and staff to improve end-of-life care in the acute