Hospice Care in the Emergency Department: An Evolving Landscape.

Background: Despite the increasing focus on goal-concordant care in the emergency department (ED), there is limited data about patients who receive a new hospice referral and the care paths of patients on hospice who present there. Objective: Describe the characteristics and clinical course of ED patients who receive a new hospice referral and those already receiving hospice care. Methods: Retrospective chart review of all adult patients presenting to the ED from January 2021 to July 2023. Results: Six patients received a new hospice referral. Of these, four had a primary diagnosis of cancer, three received a palliative care consult, and three were discharged to an inpatient hospice facility (hospice house). No patients had repeat health care encounters at our hospital. 42% (31/74) of patients enrolled in hospice required admission. Conclusion: New hospice referrals in the ED are possible but rare. Further research should investigate possible missed opportunities to provide goal-concordant care.