RCT of Default Inpatient PC Consults: Kate Courtright & Scott Halpern

Last week we talked about a trial of a nurse and social worker outpatient palliative care intervention published in JAMA.  This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. (See also our accompanying editorial, first author Ashwin Kotwal who joins today as a co-host, and a podcast I recorded with JAMA editor Preeti Malani). For context, listen to the prior podcast with Scott on “nudges” and prior podcast with Kate on who should get palliative care. Three things I love about this podcast, and why you should listen.  First, in our editorial, we expressed concern about the length of stay metric not being patient centric, though important for health systems focused on cost savings.  It was refreshing to hear Scott and Kate express similar sentiments.  Second, we wanted to know how the palliative care clinicians felt about the increased workload - and we had some glimpses into those experiences (and hope for a future publication that fleshes it out further).  Finally, we heard about next steps and lessons learned, as though this was the largest pragmatic trial of palliative care to date, it isn’t their last.  Much more to come.  And next time maybe we really will play the game where every time the word pragmatic is mentioned you have to drink