RAPID RESPONSE FOR RAPID PALLIATIVE CARE: THE IMPACT OF RAPID RESPONSE TEAM-DRIVEN PALLIATIVE CARE CONSULTATION

TOPIC: Palliative Care and End of Life Issues TYPE: Original Investigations PURPOSE: The Rapid Response Team (RRT) plays a critical role in goals-of-care (GOC) end-of-life (EOL) discussions, up to third its calls revolve around such situations. RRT can face several challenges while facilitating including limited time assess the situation, lack prior rapport with patient, inability critically ill patient communicate wishes, documentation GOC. Experts have recommended incorporation PCC into processes. METHODS: We conducted single-center retrospective cohort study at tertiary care hospital Washington, D.C. between April 2018 February 2020 which was encouraged make referral for medically appropriate patients during RR events. At this point, (PC) spoke patient's primary team see if consultation desired. There subset who initially did not get RRT-driven but were formally consulted later their hospitalization. retrospectively reviewed electronic medical records all these divided them three groups: “RRT PCC”; “PCC-later”; “PCC-declined”. Our outcome in-hospital mortality. Secondary outcomes up-triage intensive unit (ICU); length stay (LOS) ICU; hospice referral; discharge rate; de-escalation code status; rate readmission (within 30 days). RESULTS: Of 134 met criteria, 84 (63%) female; 107 (80%) African American, hypertension (n=65, 49%) chronic kidney disease (n=61, 46%) most prevalent comorbidities. Average LOS 16 days referrals’ averaging 8 after admission. 66 (49%) up-triaged ICU. status 74 (55%) de-escalated. 36 (27%) died hospital, 28 (21%) readmitted within discharge. study, 56% (n=75) had an initial PCC. no statistically significant differences characteristics (age, sex, race, comorbidities), path (length ICU up-triage), or (mortality, referral, readmission, change status) patients’ receiving those not. receive (n=59), 25% (n=15) In-hospital mortality group higher (47%, p=.02) than (29%) PCC-declined (16%) groups. CONCLUSIONS: be effective way involve PC acutely sick non-critical settings. A number declined eventually required Patients seen by rates LOS, attributed severity illness. Larger prospective studies need impact CLINICAL IMPLICATIONS: is often first encouter setting. Lack expertise part lead delayed GOC discussion event. will help initating early on acute clinical status, only beneficial family, also reduce burden team. DISCLOSURES: No relevant relationships Mansi Chaturvedi, source=Web Carroll Foley, Hunter Groninger, Steven Han, Clint Pettit,