Advance Care Planning in the Hospital: Are Palliative Care Doctors Doing Enough?

We have a great podcast this week exploring the advance care planning needs for hospitalized adults and what palliative care teams are doing (and not doing) to meet these needs. We've invited Kara Bischoff, a palliative care doctor and Assistant Professor at UCSF in the Department of Hospital Medicine, who published a paper in JAMA Internal Medicine on this very topic. Why was this JAMA IM paper so important for those who work in our field? This was a real world study, looking at over 73,000 consultations from the Palliative Care Quality Network (PCQN). They found palliative care teams consistently identified surrogates for patients, often addressed their preferences regarding life sustaining treatments, including code status, and frequently found a preference regarding life sustaining treatments that was different than what was previously documented before the consult. But rarely completed advance directives (only 3.2% of patients seen by palliative care teams) or Physicians Orders for Life-Sustaining Treatment (POLST) forms (12.3% of patients seen by palliative care teams).