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96 The acute proactive palliative liaison evaluation (APPLE) in the emergency department of Southampton general hospital

Year: 2025
Type: conference-paper
Abstract: Background Palliative Care (PC) patients are regular attendees to Emergency Departments (EDs), with studies finding that many attend not long before death. Integration of PC into the ED has been shown to improve patient and doctor wellbeing, shorten patient stay and potentially avoid admission. Despite these benefits, data is scarce from the UK. Aims To evaluate whether proactive consultant palliative care in the ED can improve patient care, reduce admission rate and support ED teams. Methods We had an electronic flag placed on patients known to the hospital palliative care team before or who were known to community palliative care. When a patient came into ED during the month of November 2024, we were alerted and went to see them proactively during working hours Monday to Friday (seeing out of hours flags at the earliest possible time). Results 108 patients flagged, and we saw 47 of them (2.35 per day). 21 patients had gone home before we could see. We generated 27 referrals to the hospital palliative care team and gave one off advice on the other 20. We offered symptom control in 22, discharge support to 17, and stopped unnecessary interventions in 7. We saw and took the lead on directly discharging 5 patients from the ED who wanted to die at home, without ED needing to see. Conclusion Even in this small trial, there is enough evidence to continue this service, providing senior decision making PC presence proactively in ED. It appears to have improved patient care, avoided admission for some and done all of this whilst reducing the pressure on an already overworked ED team.
DOI: 10.1136/spcare-2025-pcc.115
Authors: Mark Banting, Helen Crispin, Andrew Jenks, Mark Cawley, Alice Hannaford, Millie Makin
Language: English
Field: Medicine
Open Access status: bronze
OpenAlex ID: W4408550731
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