Impact Of Timing Of Palliative Care Consults On Disposition To Type Of Hospice Care.

50 Background: The 2018 ASCO palliative care guidelines recommend palliative care team (PCT) involvement within 8 weeks for patients with an advanced cancer diagnosis. However, the optimal timing and impact of PCT consults on patient disposition in the inpatient setting has not been established. We investigated whether the timing of PCT involvement for in-patients with an advanced cancer diagnosis affected disposition to a home or inpatient hospice setting. Methods: We queried Hahnemann University Hospital’s Palliative Care In-patient database from 2016-2018 for patients with advanced cancer diagnosis, estimated life expectancy of < 6 months, and recommendation for hospice. Dates of admission, initial PCT consult, discharge to an outpatient vs an inpatient hospice setting/in hospital death were examined. We then examined differences in hospice disposition and timing of PCT consults to determine the ideal consult time. Chi square analysis was used to determine differences in hospice disposition setting and timing of PCT consult. Results: We observed that 75% of PCT consults in our hospital are placed <10 days of admission. We also found that a statistically significant higher percentage of patients were discharged to a home hospice setting (35.1%) when using a PCT consult time of <10 days (p<0.01). Only 17.5% were discharged home when PCT was consulted >10 days after admission. We examined other cut-off times for consultation, but the difference in outcome was not statistically significant. Conclusions: Our findings show that a statistically significant higher percentage of patients went to a home hospice setting if PCT was consulted <10 days of admission. This suggests that early PCT involvement can result in more patients being discharged to a home hospice setting and by extension improve the quality of end of life care for patients. We aim to implement criteria for appropriate timing of PCT consults at our institution and measure post implementation data with the goal of increasing the number of patients discharged to a home hospice setting. [Table: see text]