Running the Numbers : Capitalize on the Moment: Leveraging the COVID-19 Experience to Spur Low-Value Care Reduction in North Carolina

### Background The National Institute for Health and Care Excellence (NICE) has highlighted the need access to specialist palliative care seven days a week in order improve quality of care, experience outcomes patients their families. (NICE, 2004; NICE, 2015) Little is known about demand seven-day Palliative Clinical Nurse Specialist (PCCNS) service small island \~85 000 residents. Generalist services are available on weekends holidays. Aim aim this pilot was determine for, use impact PCCNS service. Method offered between 1 October 2016 31 March 2017 by local hospice team, only provider island. established using existing team 5.2 full-time equivalent PCCNS, overseen manager. duty weekend urgent telephone calls visits. For with anticipated need, contact made as requested colleagues, 'routine' work from caseload also undertaken. publicised directly patients, health providers number, source reason calls, visits or hospital admissions were recorded analysed. Feedback sought caregivers, professionals. Results received 84 generating 59 113 additional calls. Main reasons anxiety support (32%), symptom management (28%) end life (16%). Weekend resulted 12 in-patient hospice, 58% care. Conclusion number contacts supports case bank holiday cover. A feasible beneficial