3. Match services to needs. Social work support is the right intervention for homeless individuals who return frequently to the ED. But in most cases of serious medical illness, frequent reliance on acute care is due to disease progression, increased suffering and worsening functional decline. The best approach in these cases is palliative care, available in more than 65 percent of U.S. hospitals with more than 50 beds. Ensuring adequate staffing and capacity to serve this growing, complex patient population is critical.
4. Train your workforce. Most physicians and nurses lack training in the core knowledge and skills of palliative care, including communicating prognoses, establishing care priorities, conducting family meetings, coordinating care across settings, and safely and effectively managing pain and other symptoms. High-quality, online training on these skills is widely available and affordable.
5. Track outcomes. To determine if initiatives are improving care, track outcomes like 30-day readmissions, hospital mortality and root causes of ED use. Place responsibility for these outcomes on leadership dashboards.