National Palliative Care Registry TM - 2015 Data Summary (non-pediatric Palliative Care Programs) Bed Sizes HOSPITAL METRICS Hospital Ownership 63 100.0 115 100.0 116 100.0 95 100.0 389 100.0 Public (government: federal, state, county city) 4 6.3 6 5.2 11 9.5 11 11.6 32 8.2 Not-for-profit 54 85.7 105 91.3 97 83.6 83 87.4 339 87.1 For-profit 5 7.9 4 3.5 8 6.9 1 1.1 18 4.6 Location 63 100.0 111 96.5 115 99.1 95 100.0 384 98.7 Urban 15 23.8 40 36.0 60 52.2 74 77.9 189 49.2 Suburban 24 38.1 48 43.2 46 40.0 18 18.9 136 35.4 Rural 24 38.1 23 20.7 9 7.8 3 3.2 59 15.4 Teaching Hospital 63 100.0 115 100.0 116 100.0 95 100.0 389 100.0 Yes 12 19.0 52 45.2 71 61.2 82 86.3 217 55.8 No 51 81.0 63 54.8 45 38.8 13 13.7 172 44.2 Hospital Metrics 62 98.4 115 100.0 116 100.0 94 98.9 387 99.5 Mean # of hospital admissions -- 5219.9 -- 13018.3 -- 19791.5 -- 34563.7 -- 19032.4 Mean average daily census -- 59.2 -- 146.4 -- 263.9 -- 530.8 -- 256.3 Mean hospital deaths -- 136.0 -- 269.1 -- 477.8 -- 863.6 -- 441.1 Mean # of discharges -- 5230.0 -- 12366.8 -- 22502.0 -- 33755.2 -- 19396.2 PALLIATIVE CARE PATIENT POPULATION Patient Population 63 100.0 115 100.0 116 100.0 95 100.0 389 100.0 Adults Only 57 90.5 93 80.9 97 83.6 77 81.1 324 83.3 Adults and Children 6 9.5 22 19.1 19 16.4 18 18.9 65 16.7 Patient Age Distribution 57 90.5 93 80.9 97 83.6 77 81.1 324 83.3 0 to 1 -- 0.0 -- 0.1 -- 0.1 -- 0.4 -- 0.1 2 to 17 -- 0.0 -- 0.0 -- 0.1 -- 1.1 -- 0.3 18 to 44 -- 3.7 -- 4.0 -- 6.4 -- 8.6 -- 5.8 45 to 64 -- 18.0 -- 22.4 -- 23.2 -- 27.9 -- 23.2 65 to 85 -- 49.6 -- 50.6 -- 48.5 -- 45.3 -- 48.6 86 or older -- 28.7 -- 22.9 -- 21.5 -- 16.6 -- 22.0 Patient Gender Distribution 56 88.9 92 80.0 99 85.3 79 83.2 326 83.8 Female -- 52.3 -- 52.4 -- 52.0 -- 51.3 -- 52.0 Male -- 47.7 -- 47.9 -- 47.0 -- 49.0 -- 48.0 Patient Ethnicity Distribution 50 79.4 75 65.2 84 72.4 65 68.4 274 70.4 Black/African America non-hispanic -- 6.3 -- 7.9 -- 10.2 -- 13.6 -- 9.7 White/Caucasian non-hispanic -- 65.6 -- 52.2 -- 52.9 -- 45.6 -- 53.0 Asian non-hispanic -- 2.9 -- 1.4 -- 2.8 -- 2.2 -- 2.2 American Indian/Alaska Native non-hispanic -- 0.3 -- 0.7 -- 0.4 -- 0.3 -- 0.5 Hawaiian Native/Pacific Islander non-hispanic -- 0.2 -- 0.1 -- 0.3 -- 0.1 -- 0.2 Hispanic / Latino -- 3.2 -- 2.4 -- 3.7 -- 5.3 -- 3.6 PATIENT VISITS Initial Consults 62 98.4 114 99.1 116 100.0 93 97.9 385 99.0 Mean # of initial consults -- 353.4 -- 539.9 -- 830.2 -- 1241.7 -- 767.7 Median # of initial consults -- 312.0 -- 467.0 -- 728.0 -- 1136.0 -- 637.0 Minimum -- 11 -- 36 -- 151 -- 15 -- 11 Maximum -- 1228 -- 1271 -- 3278 -- 5780 -- 5780 Page 1 of 10
Penetration 62 98.4 114 99.1 116 100.0 93 97.9 385 99.0 Mean Penetration -- 7.3 -- 4.7 -- 4.3 -- 3.7 -- 4.8 Median Penetration -- 6.3 -- 3.8 -- 3.7 -- 3.6 -- 3.9 Minimum -- 0.3 -- 0.3 -- 1.0 -- 0.1 -- 0.1 Maximum -- 21.2 -- 14.3 -- 22.4 -- 12.8 -- 22.4 Billable Follow-up Visits 35 55.6 60 52.2 67 57.8 58 61.1 220 56.6 Mean # of billable follow up visits -- 484.0 -- 891.0 -- 1427.4 -- 2838.2 -- 1503.0 Median # of billable follow up visits -- 256.0 -- 596.5 -- 1077.0 -- 2355.5 -- 984.0 Mean # of billable follow up visits per initial consult -- 1.3 -- 1.5 -- 1.9 -- 2.2 -- 1.8 Median # of billable follow up visits per initial consult -- 1.1 -- 1.4 -- 1.8 -- 1.9 -- 1.6 Palliative Care Team Role 54 85.7 103 89.6 105 90.5 84 88.4 346 88.9 100% Consult Only 26 48.1 66 64.1 64 61.0 54 64.3 210 60.7 100% Primary 1 1.9 0 0.0 0 0.0 0 0.0 1 0.3 100% Co-manage 12 22.2 15 14.6 13 12.4 9 10.7 49 14.2 100% Depends on Circumstances 4 7.4 3 2.9 8 7.6 5 6.0 20 5.8 Observation Beds & Emergency Department 63 100.0 112 97.4 115 99.1 93 97.9 383 98.5 Sees Patients in Observation Beds 40 63.5 71 63.4 64 55.7 51 54.8 226 59.0 Mean # of Obs Patients -- 28.7 28.5 29.8 41.9 32.0 Sees Patients in Emergency Department 39 61.9 89 79.5 92 80.0 70 75.3 290 75.7 Mean # of ED Patients -- 9.3 -- 18.8 -- 24.5 -- 60.6 -- 29.0 SCREENING AND REFERRALS Standardized Trigger Tool 63 100.0 114 99.1 115 99.1 93 97.9 385 99.0 No standardized trigger tool 35 55.6 73 64.0 83 72.2 57 61.3 248 64.4 Yes, has standardized trigger tool 28 44.4 40 35.1 32 27.8 36 38.7 136 35.3 Referral Source Location 55 87.3 93 80.9 90 77.6 70 73.7 308 79.2 Medical/Surgical 50 90.9 89 95.7 89 98.9 66 94.3 294 95.5 Mean Percentage -- 49.1 -- 41.6 -- 39.3 -- 36.7 -- 41.1 At least 25% of all referrals 45 81.8 66 71.0 62 68.9 51 72.9 224 72.7 At least 50% of all referrals 31 56.4 36 38.7 25 27.8 17 24.3 109 35.4 At least 75% of all referrals 11 20.0 12 12.9 7 7.8 2 2.9 32 10.4 Intensive Care Unit (ICU) 49 89.1 90 96.8 89 98.9 68 97.1 296 96.1 Mean Percentage -- 23.4 -- 24.9 -- 25.9 -- 28.7 -- 25.8 At least 25% of all referrals 25 45.5 40 43.0 43 47.8 44 62.9 152 49.4 At least 50% of all referrals 3 5.5 4 4.3 5 5.6 6 8.6 18 5.8 Oncology 8 14.5 39 41.9 58 64.4 53 75.7 158 51.3 Mean Percentage -- 5.1 -- 7.1 -- 10.0 -- 13.4 -- 9.0 At least 25% of all referrals 3 5.5 8 8.6 9 10.0 14 20.0 34 11.0 Emergency Department 28 50.9 62 66.7 74 82.2 39 55.7 203 65.9 Mean Percentage -- 1.3 -- 2.4 -- 3.8 -- 3.2 -- 2.8 Telemetry / Step-down 26 47.3 59 63.4 64 71.1 35 50.0 184 59.7 Mean Percentage -- 12.2 -- 14.4 -- 13.4 -- 8.4 -- 12.3 At least 25% of all referrals 10 18.2 30 32.3 18 20.0 9 12.9 67 21.8 At least 50% of all referrals 4 7.3 0 0.0 0 0.0 0 0.0 4 1.3 Gastroenterology/Hepatology 0 0.0 4 4.3 6 6.7 15 21.4 25 8.1 Mean Percentage -- 0.0 -- 0.3 -- 0.2 -- 0.8 -- 0.3 General Pediatrics 1 1.8 2 2.2 4 4.4 6 8.6 13 4.2 Mean Percentage -- 0.0 -- 0.0 -- 0.1 -- 0.1 -- 0.1 Geriatrics ACE Unit 3 5.5 7 7.5 8 8.9 1 1.4 19 6.2 Page 2 of 10
Mean Percentage -- 0.4 -- 0.7 -- 0.9 -- 1.2 -- 0.8 MD Office / Home (direct admit) 4 8.2 8 8.9 5 5.6 4 5.9 21 6.8 Mean Percentage -- 1.8 -- 0.5 -- 0.2 -- 0.1 -- 0.6 Hospice 0 0.0 4 4.4 3 3.4 3 4.4 10 3.2 Mean Percentage -- 0.0 -- 0.1 -- 0.2 -- 0.8 -- 0.1 Referring Specialist 54 85.7 90 78.3 86 74.1 65 68.4 295 75.8 Hospitalist 50 92.6 82 91.1 79 91.9 59 90.8 270 91.5 Mean Percentage -- 64.1 -- 53.5 -- 44.1 -- 33.4 -- 48.3 At least 25% of all referrals 48 88.9 76 84.4 69 80.2 40 61.5 233 79.0 At least 50% of all referrals 43 79.6 62 68.9 40 46.5 17 26.2 162 54.9 At least 75% of all referrals 22 40.7 21 23.3 9 10.5 2 3.1 54 18.3 Oncologist 37 68.5 72 80.0 76 88.4 59 90.8 244 82.7 Mean Percentage -- 6.6 -- 5.8 -- 6.2 -- 11.6 -- 7.4 At least 25% of all referrals 3 5.6 5 5.6 4 4.7 9 13.8 21 7.1 Cardiologist 30 55.6 63 70.0 72 83.7 58 89.2 223 75.6 Mean Percentage -- 2.0 -- 2.2 -- 3.3 -- 8.4 -- 3.8 Nephrologist 19 35.2 41 45.6 51 59.3 35 53.8 146 49.5 Mean Percentage -- 1.0 -- 0.9 -- 1.0 -- 1.7 -- 1.1 Pulmonary/Critical Care 38 70.4 82 91.1 83 96.5 60 92.3 263 89.2 Mean Percentage -- 6.8 -- 12.1 -- 15.9 -- 14.1 -- 12.7 Surgery 38 70.4 57 63.3 67 77.9 57 87.7 219 74.2 Mean Percentage -- 1.8 -- 2.0 -- 3.9 -- 6.1 -- 3.4 Neurologist 6 11.1 36 40.0 49 57.0 44 67.7 135 45.8 Mean Percentage -- 0.5 -- 0.7 -- 1.2 -- 2.8 -- 1.3 Gastroenterologist/Hepatologist 3 5.6 20 22.2 25 29.1 25 38.5 73 24.7 Mean Percentage -- 0.1 -- 0.4 -- 0.3 -- 0.8 -- 0.4 Internal Medicine 18 33.3 48 53.3 49 57.0 31 47.7 146 49.5 Mean Percentage -- 5.3 -- 12.2 -- 12.3 -- 9.2 -- 10.3 Family Medicine 17 31.5 42 46.7 41 47.7 28 43.1 128 43.4 Mean Percentage -- 4.9 -- 3.4 -- 4.1 -- 1.8 -- 3.5 Other referring clinical specialist 33 61.1 53 58.9 57 66.3 41 63.1 184 62.4 Mean Percentage -- 3.4 -- 4.5 -- 4.7 -- 4.6 -- 4.4 TJC CERTIFICATION, SERVICES INTEGRATION Joint Commission Advanced Certification for Palliative Care 61 96.8 114 99.1 114 98.3 93 97.9 382 98.2 Yes 2 3.3 9 7.9 4 3.5 9 9.7 24 6.3 Yes, and have been re-certified 0 0.0 5 4.4 8 7.0 11 11.8 24 6.3 Preparing to apply 6 9.8 6 5.3 12 10.5 15 16.1 39 10.2 Not eligible 9 14.8 16 14.0 12 10.5 7 7.5 44 11.5 Program does not have requirements 29 47.5 52 45.6 51 44.7 31 33.3 163 42.7 Not Planning on applying 15 24.6 26 22.8 27 23.7 20 21.5 88 23.0 Relationship: Hospice 62 98.4 114 99.1 116 100.0 94 98.9 386 99.2 No relationship exists 1 1.6 3 2.6 4 3.4 0 0.0 8 2.1 One administrative entity 9 14.5 18 15.8 16 13.8 6 6.4 49 12.7 Administratively separate 20 32.3 38 33.3 41 35.3 36 38.3 135 35.0 Contracts in place 22 35.5 33 28.9 37 31.9 31 33.0 123 31.9 Informally collaborate 29 46.8 49 43.0 37 31.9 36 38.3 151 39.1 Other 0 0.0 3 2.6 6 5.2 4 4.3 13 3.4 Relationship: ICU 62 98.4 115 100.0 115 99.1 93 97.9 385 99.0 Page 3 of 10
Rarely see ICU patients 3 4.8 4 3.5 2 1.7 2 2.2 11 2.9 No formal coordination 25 40.3 52 45.2 49 42.6 27 29.0 153 39.7 Work collaboratively to develop system 31 50.0 55 47.8 48 41.7 51 54.8 185 48.1 ICU has plans for palliative care 6 9.7 14 12.2 23 20.0 22 23.7 65 16.9 Relationship: Emergency Medicine 62 98.4 115 100.0 115 99.1 94 98.9 386 99.2 Rarely see EM patients 27 43.5 47 40.9 45 39.1 28 29.8 147 38.1 No formal coordination 28 45.2 47 40.9 59 51.3 36 38.3 170 44.0 Work collaboratively to develop system 7 11.3 20 17.4 14 12.2 27 28.7 68 17.6 EM has plans for PC care 1 1.6 4 3.5 2 1.7 8 8.5 15 3.9 Electronic Health Record Hospital EHR 62 98.4 115 100.0 116 100.0 94 98.9 387 99.5 Has a Hospital EHR 59 95.2 114 99.1 114 98.3 94 100.0 381 98.4 Cerner 12 19.4 37 32.2 31 26.7 23 24.5 103 26.6 Epic 17 27.4 34 29.6 39 33.6 49 52.1 139 35.9 Meditech 14 22.6 21 18.3 14 12.1 2 2.1 51 13.2 Palliative Care Program EHR 62 98.4 115 100.0 116 100.0 94 98.9 387 99.5 Has a Palliative Care Program EHR 57 91.9 110 95.7 105 90.5 89 94.7 361 93.3 Cerner 13 21.0 34 29.6 26 22.4 19 20.2 92 23.8 Epic 17 27.4 34 29.6 39 33.6 45 47.9 135 34.9 Meditech 13 21.0 19 16.5 12 10.3 2 2.1 46 11.9 Custom Palliative Care Reports 57 90.5 108 93.9 105 90.5 88 92.6 358 92.0 Yes, gets custom palliative care reports from EHR 24 42.1 51 47.2 58 55.2 43 48.9 176 49.2 No 33 57.9 57 52.8 47 44.8 45 51.1 182 50.8 DIAGNOSIS AND CODE STATUS Diagnosis 55 87.3 94 81.7 89 76.7 74 77.9 312 80.2 Cancer 50 90.9 88 93.6 88 98.9 74 100.0 300 96.2 Mean Percentage -- 23.3 -- 24.9 -- 25.7 -- 31.3 -- 26.4 At least 25% of all referrals 20 36.4 49 52.1 44 49.4 44 59.5 157 50.3 At least 50% of all referrals 3 5.5 7 7.4 7 7.9 15 20.3 32 10.3 Cardiac 46 83.6 89 94.7 83 93.3 71 95.9 289 92.6 Mean Percentage -- 12.7 -- 12.9 -- 12.2 -- 14.0 -- 12.9 At least 25% of all referrals 6 10.9 4 4.3 5 5.6 4 5.4 19 6.1 Pulmonary 50 90.9 89 94.7 82 92.1 70 94.6 291 93.3 Mean Percentage -- 13.5 -- 13.4 -- 11.4 -- 10.5 -- 12.1 At least 25% of all referrals 4 7.3 7 7.4 3 3.4 3 4.1 17 5.4 Complex chronic/failure to thrive 31 56.4 67 71.3 60 67.4 50 67.6 208 66.7 Mean Percentage -- 6.8 -- 7.0 -- 6.1 -- 5.0 -- 6.2 At least 25% of all referrals 3 5.5 5 0.0 4 0.0 4 5.4 16 5.1 Renal 45 81.8 84 89.4 80 89.9 68 91.9 277 88.8 Mean Percentage -- 3.7 -- 4.4 -- 3.7 -- 3.1 -- 3.8 Vascular 16 29.1 37 39.4 42 47.2 36 48.6 131 42.0 Mean Percentage -- 0.6 -- 1.0 -- 1.0 -- 1.1 -- 0.9 Congenital / Chromosomal 3 5.5 11 11.7 10 11.2 12 16.2 36 11.5 Mean Percentage -- 0.1 -- 0.1 -- 0.1 -- 0.2 -- 0.1 Infectious/Immunological 26 47.3 68 72.3 59 66.3 49 66.2 202 64.7 Mean Percentage -- 4.1 -- 6.0 -- 5.3 -- 5.0 -- 5.2 Gastrointestinal 24 43.6 53 56.4 53 59.6 47 63.5 177 56.7 Page 4 of 10
Mean Percentage -- 1.9 -- 2.1 -- 2.2 -- 2.7 -- 2.3 Hepatic 31 56.4 63 67.0 60 67.4 48 64.9 202 64.7 Mean Percentage -- 1.9 -- 2.6 -- 2.2 -- 2.5 -- 2.3 Hematology 12 21.8 17 18.1 21 23.6 23 31.1 73 23.4 Mean Percentage -- 1.0 -- 0.2 -- 0.5 -- 0.8 -- 0.6 Endocrine/Metabolic 11 20.0 22 23.4 23 25.8 19 25.7 75 24.0 Mean Percentage -- 0.3 -- 0.6 -- 0.5 -- 0.7 -- 0.5 In-utero complication / condition 1 1.8 2 2.1 0 0.0 5 6.8 8 2.6 Mean Percentage -- 0.0 -- 0.0 -- 0.0 -- 0.1 -- 0.0 Neurologic/stroke/neurodegenerative 41 74.5 80 85.1 77 86.5 62 83.8 260 83.3 Mean Percentage -- 5.6 -- 7.3 -- 8.9 -- 8.3 -- 7.7 Dementia 35 63.6 67 71.3 53 59.6 46 62.2 201 64.4 Mean Percentage -- 5.6 -- 5.5 -- 4.0 -- 3.3 -- 4.6 Trauma 16 29.1 41 43.6 45 50.6 43 58.1 145 46.5 Mean Percentage -- 0.9 -- 1.4 -- 1.7 -- 1.6 -- 1.4 Code Status (mean %) 43 68.3 72 62.6 70 60.3 60 63.2 245 63.0 Full Code -- 34.9 -- 33.2 -- 42.0 -- 27.8 -- 34.7 Limited Code -- 4.4 -- 2.7 -- 2.4 -- 3.8 -- 3.2 DNR/DNI -- 35.9 -- 24.3 -- 34.1 -- 21.8 -- 28.5 Unknown -- 24.5 -- 38.8 -- 42.8 -- 46.7 -- 39.4 DISCHARGES Discharges 54 85.7 98 87.5 95 82.6 75 80.6 322 84.1 Discharged Alive -- 82.8 -- 80.3 -- 76.6 -- 76.1 -- 78.6 Died on Palliative Care -- 17.2 -- 19.7 -- 23.4 -- 23.9 -- 21.4 Discharge - Place of Origin (mean %) 40 63.5 66 57.4 66 56.9 54 56.8 226 58.1 Discharged to Same Place as Origin -- 19.4 -- 18.5 -- 13.3 -- 14.1 -- 16.1 Discharged to Different than Origin -- 14.2 -- 17.9 -- 14.6 -- 12.8 -- 15.1 Unknown Status -- 66.4 -- 63.6 -- 72.5 -- 73.2 -- 69.0 Discharge Location (mean %) 52 82.5 94 81.7 91 78.4 76 80.0 313 80.5 Home (including Home Hospice & Assisted Living) -- 41.7 -- 42.5 -- 40.7 -- 40.6 -- 41.4 Skilled Nursing Facility (SNF) -- 28.0 -- 24.9 -- 25.0 -- 19.1 -- 24.0 Inpatient or Residential Hospice -- 14.9 -- 15.2 -- 17.7 -- 18.2 -- 16.6 Acute Inpatient Rehabilitation Facility -- 0.9 -- 2.1 -- 1.1 -- 1.6 -- 1.5 Long-term Acute Care Hospital (LTAC) -- 3.8 -- 2.1 -- 2.5 -- 2.3 -- 2.6 General Hospital -- 1.8 -- 1.8 -- 1.2 -- 1.6 -- 1.6 Other -- 5.4 -- 6.9 -- 7.7 -- 10.7 -- 7.8 LENGTH OF STAY Initial Consult Completed 37 58.7 72 62.6 60 51.7 52 54.7 221 56.8 Within 1 Day of Referral -- 64.8 -- 67.2 -- 60.9 -- 67.3 -- 65.1 Within 1 Day of Hospital Admission -- 34.5 -- 30.1 -- 29.7 -- 27.9 -- 30.4 Not Able to be Seen Before Discharge -- 7.4 -- 7.4 -- 5.9 -- 6.6 -- 6.8 Discharged Alive 42 66.7 79 68.7 78 67.2 65 68.4 264 67.9 Admission to Consult: Mean -- 3.3 -- 4.8 -- 5.0 -- 5.8 -- 4.9 Admission to Consult: Median -- 2.3 -- 3.3 -- 3.3 -- 3.6 -- 3.2 Consult to Discharge: Mean -- 5.4 -- 5.1 -- 5.7 -- 6.3 -- 5.6 Consult to Discharge: Median -- 4.4 -- 3.7 -- 5.1 -- 5.5 -- 4.6 Overall: Mean -- 8.7 -- 10.0 -- 10.5 -- 11.8 -- 10.4 Page 5 of 10
Overall: Median -- 7.4 -- 7.6 -- 8.1 -- 10.0 -- 8.2 Died on Palliative Care 40 63.5 72 62.6 75 64.7 55 57.9 242 62.2 Admission to Consult: Mean -- 4.3 -- 5.3 -- 6.2 -- 8.0 -- 6.0 Admission to Consult: Median -- 3.0 -- 3.3 -- 3.9 -- 4.5 -- 3.7 Consult to Discharge: Mean -- 4.9 -- 4.7 -- 4.7 -- 5.5 -- 4.9 Consult to Discharge: Median -- 2.4 -- 2.9 -- 3.0 -- 3.6 -- 3.0 Overall: Mean -- 8.7 -- 9.8 -- 10.5 -- 13.0 -- 10.5 Overall: Median -- 6.0 -- 7.2 -- 8.3 -- 8.9 -- 7.7 Readmission within 30 days 33 52.4 58 50.4 54 46.6 35 36.8 180 46.3 Mean number of patients readmitted within 30 days -- 21.9 -- 43.5 -- 87.3 -- 124.5 -- 68.4 Readmission Rate (# readmitted / # discharged alive) 31 49.2 57 49.6 53 45.7 35 36.8 176 45.2 Mean -- 13.4 -- 12.2 -- 15.7 -- 13.8 -- 13.8 Median -- 8.2 -- 9.0 -- 13.0 -- 10.6 -- 10.6 STANDARDIZED PROCESSES Plans in Place 54 85.7 97 84.3 99 85.3 81 85.3 331 85.1 Marketing 29 53.7 47 48.5 49 49.5 39 48.1 164 49.5 Bereavement 24 44.4 53 54.6 58 58.6 52 64.2 187 56.5 Education 31 57.4 72 74.2 82 82.8 64 79.0 249 75.2 Quality Improvement 35 64.8 76 78.4 70 70.7 62 76.5 243 73.4 Patient and Family Satisfaction Survey 59 93.7 110 95.7 113 97.4 91 95.8 373 95.9 % of programs that measure patient/family satisfaction -- 42.4 -- 38.2 -- 34.5 -- 39.6 -- 38.1 If yes, % of programs that use a standard instrument -- 66.7 -- 81.0 -- 81.6 -- 75.0 -- 77.1 If yes, mean survey response rate -- 18.2 -- 26.1 -- 15.8 -- 19.1 -- 19.7 Telemedicine 60 95.2 110 95.7 113 97.4 89 93.7 372 95.6 Yes, Audio and Video 1 1.7 8 7.3 2 1.8 6 6.7 17 4.6 No, audio only (phone only) 7 11.7 10 9.1 8 7.1 9 10.1 34 9.1 No, neither 52 86.7 92 83.6 103 91.2 74 83.1 321 86.3 Team Wellness 59 93.7 112 97.4 114 98.3 90 94.7 375 96.4 Yes, program has policies promoting team wellness 34 57.6 64 57.1 72 63.2 41 45.6 211 56.3 No team wellness policies 25 42.4 48 42.9 42 36.8 49 54.4 164 43.7 PAIN AND DYSPNEA Pain Dyspnea Percent of patients screened for pain 48 76.2 76 66.1 79 68.1 64 67.4 267 68.6 Mean percent -- 94.7 -- 93.1 -- 93.9 -- 95.7 -- 94.0 If screened, percent that screened positive for pain 24 38.1 33 28.7 35 30.2 25 26.3 117 30.1 Mean percent -- 55.6 -- 53.1 -- 53.6 -- 55.5 -- 54.3 If positive, percent with clinical assessment in 24 hrs 25 39.7 35 30.4 36 31.0 26 27.4 122 31.4 Mean percent -- 97.0 -- 89.1 -- 99.2 -- 95.9 -- 95.2 If positive, percent with pain improvement in 48 hrs 14 22.2 24 20.9 26 22.4 15 15.8 79 20.3 Mean percent -- 57.6 -- 62.1 -- 79.8 -- 81.5 -- 70.8 Percent of patients screened for dyspnea 38 60.3 70 60.9 69 59.5 55 57.9 232 59.6 Mean percent -- 93.2 -- 85.5 -- 92.2 -- 92.5 -- 90.4 If screened, percent that screened positive for dyspnea 21 33.3 33 28.7 37 31.9 23 24.2 114 29.3 Mean percent -- 48.8 -- 39.4 -- 27.4 -- 30.0 -- 35.3 If positive, percent treated within 24 hrs 22 34.9 36 31.3 43 37.1 24 25.3 125 32.1 Mean percent -- 92.3 -- 74.3 -- 81.9 -- 86.3 -- 82.4 Page 6 of 10
GOALS OF CARE If positive, percent with dyspnea improvement in 48 hrs 15 23.8 24 20.9 31 26.7 17 17.9 87 22.4 Mean percent -- 43.6 -- 46.5 -- 53.1 -- 62.8 -- 51.5 Chart documentation of Goals of care 44 69.8 70 60.9 62 53.4 46 48.4 222 57.1 Mean percent -- 84.8 -- 90.7 -- 88.9 -- 89.4 -- 88.8 Surrogate decision maker 21 33.3 45 39.1 46 39.7 32 33.7 144 37.0 Mean percent -- 97.0 -- 89.8 -- 87.4 -- 85.1 -- 89.0 Psychological or emotional needs 24 38.1 41 35.7 43 37.1 31 32.6 139 35.7 Mean percent -- 86.6 -- 81.1 -- 84.8 -- 82.5 -- 83.5 Spiritual concerns 24 38.1 44 38.3 39 33.6 31 32.6 138 35.5 Mean percent -- 77.2 -- 76.3 -- 77.8 -- 79.6 -- 77.6 Life sustaining treatment preferences 26 41.3 36 31.3 34 29.3 19 20.0 115 29.6 Mean percent before initial consultation -- 56.2 -- 52.8 -- 53.3 -- 59.1 -- 54.8 Mean percent after initial consultation -- 80.4 -- 75.0 -- 82.4 -- 82.3 -- 79.6 Advance directive 29 46.0 43 37.4 36 31.0 23 24.2 131 33.7 Mean percent before initial consultation -- 51.6 -- 37.5 -- 38.8 -- 41.9 -- 41.9 Mean percent after initial consultation -- 75.2 -- 62.4 -- 59.9 -- 67.5 -- 65.6 Do Not Resuscitate (DNR) 26 41.3 34 29.6 34 29.3 19 20.0 113 29.0 Mean percent before initial consultation -- 42.8 -- 35.3 -- 40.7 -- 35.3 -- 38.6 Mean percent after initial consultation -- 68.4 -- 60.6 -- 62.5 -- 63.8 -- 63.5 Physician Orders for Life-Sustaining Treatment (POLST 16 25.4 23 20.0 14 12.1 10 10.5 63 16.2 Mean percent before initial consultation -- 30.4 -- 25.6 -- 18.3 -- 15.2 -- 23.1 Mean percent after initial consultation -- 41.2 -- 48.2 -- 27.9 -- 26.1 -- 39.0 Percent of consults resulting in change in treatment plan 19 30.2 28 24.3 26 22.4 13 13.7 86 22.1 Mean percent -- 54.1 -- 47.8 -- 62.9 -- 59.2 -- 55.5 Of patients with full code, percent with status change 28 44.4 40 34.8 40 34.5 21 22.1 129 33.2 Mean percent -- 48.9 -- 43.5 -- 44.6 -- 47.4 -- 45.6 STAFFING Staffing model 59 93.7 104 90.4 110 94.8 90 94.7 363 93.3 Embedded, program is internal to hospital 48 81.4 84 80.8 83 75.5 72 80.0 287 79.1 Program is partially internal with some contracted services 8 13.6 18 17.3 18 16.4 16 17.8 60 16.5 Program is administered by an outside contracted agency 3 5.1 2 1.9 9 8.2 2 2.2 16 4.4 Total Staff Head Count (funded, in-kind and volunteer) 50 79.4 97 84.3 106 91.4 83 87.4 336 86.4 Mean Head Count -- 7.3 -- 7.4 -- 7.6 -- 12.7 -- 8.7 Median Head Count -- 6.0 -- 6.0 -- 7.0 -- 11.0 -- 7.0 Minimum Head Count -- 2.0 -- 1.0 -- 1.0 -- 1.0 -- 1.0 Maximum Head Count -- 27.0 -- 65.0 -- 27.0 -- 48.0 -- 65.0 Physician (DO/MD) 35 70.0 82 84.5 87 82.1 78 94.0 282 83.9 Mean Head Count -- 1.1 -- 1.4 -- 1.7 -- 3.6 -- 2.0 Advanced Practice Nurse (APRN) 37 74.0 74 76.3 84 79.2 77 92.8 272 81.0 Mean Head Count -- 1.1 -- 1.4 -- 1.7 -- 3.6 -- 2.0 Physicians Assistant 1 2.0 3 3.1 4 3.8 9 10.8 17 5.1 Mean Head Count -- 0.0 -- 0.0 -- 0.1 -- 0.1 -- 0.1 Registered Nurse (RN) 20 40.0 47 48.5 49 46.2 38 45.8 154 45.8 Mean Head Count -- 1.0 -- 0.8 -- 0.7 -- 0.9 -- 0.8 Medical Residents 0 0.0 1 1.0 0 0.0 1 1.2 2 0.6 Page 7 of 10
Mean Head Count -- 0.0 -- 0.0 -- 0.0 -- 0.0 -- 0.0 Physician Fellows 1 2.0 2 2.1 6 5.7 22 26.5 31 9.2 Mean Head Count -- 0.0 -- 0.1 -- 0.2 -- 0.6 -- 0.2 Licensed Practical Nurse (LPN) 1 2.0 0 0.0 1 0.9 0 0.0 2 0.6 Mean Head Count -- 0.0 -- 0.0 -- 0.0 -- 0.0 -- 0.0 Psychologist 1 2.0 4 4.1 2 1.9 7 8.4 14 4.2 Mean Head Count -- 0.0 -- 0.1 -- 0.0 -- 0.1 -- 0.0 Psychiatrist 1 2.0 4 4.1 0 0.0 2 2.4 7 2.1 Mean Head Count -- 0.0 -- 0.1 -- 0.0 -- 0.0 -- 0.0 Social Worker 34 68.0 62 63.9 66 62.3 57 68.7 219 65.2 Mean Head Count -- 1.1 -- 1.1 -- 0.9 -- 1.2 -- 1.1 Chaplain/Spiritual Care 32 64.0 54 55.7 64 60.4 54 65.1 204 60.7 Mean Head Count -- 0.9 -- 1.1 -- 1.0 -- 0.8 -- 1.0 Physical/Occupational Therapist 7 14.0 1 1.0 1 0.9 1 1.2 10 3.0 Mean Head Count -- 0.2 -- 0.1 -- 0.0 -- 0.0 -- 0.7 Massage Therapist 1 2.0 2 2.1 3 2.8 4 4.8 10 3.0 Mean Head Count -- 0.0 -- 0.0 -- 0.0 -- 0.0 -- 0.0 Music/Art Therapist 2 4.0 2 2.1 5 4.7 6 7.2 15 4.5 Mean Head Count -- 0.1 -- 0.0 -- 0.1 -- 0.1 -- 0.1 Doula 1 2.0 0 0.0 0 0.0 2 2.4 3 0.9 Mean Head Count -- 0.1 -- 0.0 -- 0.0 -- 0.0 -- 0.1 Child Life Specialist 3 6.0 0 0.0 2 1.9 4 4.8 9 2.7 Mean Head Count -- 0.1 -- 0.0 -- 0.0 -- 0.1 -- 0.0 Dietician/Nutritionist 9 18.0 3 3.1 2 1.9 2 2.4 16 4.8 Mean Head Count -- 0.2 -- 0.0 -- 0.0 -- 0.0 -- 0.1 Pharmacist 9 18.0 9 9.3 4 3.8 13 15.7 35 10.4 Mean Head Count -- 0.3 -- 0.3 -- 0.0 -- 0.2 -- 0.2 Ethicist 1 2.0 2 2.1 5 4.7 7 8.4 15 4.5 Mean Head Count -- 0.0 -- 0.0 -- 0.0 -- 0.1 -- 0.0 Hospice Liaison 4 8.0 7 7.2 6 5.7 6 7.2 23 6.8 Mean Head Count -- 0.1 -- 0.1 -- 0.1 -- 0.1 -- 0.1 Medical Director (non-clinical time) 8 16.0 23 23.7 32 30.2 29 34.9 92 27.4 Mean Head Count -- 0.2 -- 0.2 -- 0.3 -- 0.4 -- 0.3 Administrative Support 16 32.0 28 28.9 39 36.8 44 53.0 127 37.8 Mean Head Count -- 0.4 -- 0.3 -- 0.4 -- 0.7 -- 0.5 Total Staff Full-time Equivalent (funded, in-kind and volunteer) 51 81.0 99 86.1 107 92.2 79 83.2 336 86.4 Mean FTE -- 3.5 -- 4.7 -- 4.7 -- 8.7 -- 5.5 Median FTE -- 2.5 -- 3.3 -- 4.1 -- 7.4 -- 4.1 Minimum FTE -- 0.5 -- 0.5 -- 0.3 -- 0.4 -- 0.3 Maximum FTE -- 18.0 -- 60.0 -- 18.0 -- 38.7 -- 60.0 Physician (DO/MD) 34 66.7 77 77.8 85 79.4 74 93.7 270 80.4 Mean FTE -- 0.5 -- 0.9 -- 1.0 -- 2.3 -- 1.2 Advanced Practice Nurse (APRN) 40 78.4 76 76.8 84 78.5 72 91.1 272 81.0 Mean FTE -- 1.1 -- 1.1 -- 1.4 -- 2.0 -- 1.4 Physicians Assistant 1 2.0 3 3.0 4 3.7 9 11.4 17 5.1 Mean FTE -- 0.0 -- 0.0 -- 0.0 -- 0.1 -- 0.1 Registered Nurse (RN) 19 37.3 48 48.5 48 44.9 34 43.0 149 44.3 Mean FTE -- 0.6 -- 0.6 -- 0.6 -- 0.7 -- 0.6 Medical Residents 2 3.9 1 1.0 1 0.9 4 5.1 8 2.4 Page 8 of 10
Physician Fellows 0 0.0 2 2.0 6 5.6 20 25.3 28 8.3 Mean FTE -- 0.0 -- 0.0 -- 0.1 -- 0.5 -- 0.2 Licensed Practical Nurse (LPN) 1 2.0 0 0.0 1 0.9 0 0.0 2 0.6 Psychologist 1 2.0 4 4.0 1 0.9 7 8.9 13 3.9 Psychiatrist 0 0.0 5 5.1 0 0.0 2 2.5 7 2.1 Mean FTE -- 0.0 -- 0.1 -- 0.0 -- 0.0 -- 0.0 Social Worker 33 64.7 61 61.6 67 62.6 59 74.7 220 65.5 Mean FTE -- 0.5 -- 0.7 -- 0.6 -- 1.2 -- 0.8 Chaplain/Spiritual Care 25 49.0 47 47.5 62 57.9 49 62.0 183 54.5 Mean FTE -- 0.2 -- 0.4 -- 0.4 -- 0.5 -- 0.4 Physical/Occupational Therapist 5 9.8 1 1.0 1 0.9 1 1.3 8 2.4 Mean FTE -- 0.1 -- 0.1 -- 0.0 -- 0.0 -- 0.0 Massage Therapist 1 2.0 1 1.0 3 2.8 4 5.1 9 2.7 Music/Art Therapist 2 3.9 1 1.0 4 3.7 5 6.3 12 3.6 Doula 1 2.0 0 0.0 0 0.0 2 2.5 3 0.9 Child Life Specialist 3 5.9 0 0.0 1 0.9 2 2.5 6 1.8 Dietician/Nutritionist 6 11.8 4 4.0 2 1.9 2 2.5 14 4.2 Mean FTE -- 0.1 -- 0.0 -- 0.0 -- 0.0 -- 0.0 Pharmacist 6 11.8 8 8.1 4 3.7 12 15.2 30 8.9 Mean FTE -- 0.1 -- 0.2 -- 0.0 -- 0.1 -- 0.1 Ethicist 1 2.0 0 0.0 4 3.7 6 7.6 11 3.3 Hospice Liaison 1 2.0 5 5.1 8 7.5 6 7.6 20 6.0 Mean FTE -- 0.0 -- 0.1 -- 0.1 -- 0.1 -- 0.1 Medical Director (non-clinical time) 9 17.6 22 22.2 35 32.7 29 36.7 95 28.3 Mean FTE -- 0.0 -- 0.1 -- 0.1 -- 0.1 -- 0.1 Administrative Support 16 31.4 30 30.3 39 36.4 39 49.4 124 36.9 Mean FTE -- 0.2 -- 0.2 -- 0.2 -- 0.5 -- 0.3 Complete Interdisciplinary Team 59 93.7 108 93.9 111 95.7 91 95.8 369 94.9 Physician, Nurse (APRN or RN), Social Worker, and Chaplain 17 28.8 47 43.5 44 39.6 55 60.4 163 44.2 Program Lead 51 81.0 99 86.1 107 92.2 79 83.2 336 86.4 Physician-led (1 FTE or more physician) 12 23.5 35 35.4 55 51.4 71 89.9 173 51.5 Physician-led (Less than 1 FTE physician) 22 43.1 42 42.4 30 28.0 3 3.8 97 28.9 APRN-led (No physician, at least 1 FTE APRN) 13 25.5 15 15.2 15 14.0 2 2.5 45 13.4 APRN-led (No physician, less than 1 FTE APRN) 2 3.9 0 0.0 1 0.9 0 0.0 3 0.9 RN-led (No physician, no APRN, at least 1 FTE RN) 2 3.9 5 5.1 5 4.7 0 0.0 12 3.6 Workload 51 81.0 99 86.1 107 92.2 79 83.2 336 86.4 Initial Consults per 1 FTE APRN or Physician -- 392.4 -- 435.4 -- 425.0 -- 318.8 -- 397.6 Initial Consults per 1 FTE of Interdisciplinary Team -- 322.8 -- 252.9 -- 329.9 -- 288.0 -- 296.8 Initial Consults per 1 FTE of all palliative care staff -- 155.0 -- 189.2 -- 231.6 -- 228.6 -- 206.8 Palliative Care Certification 53 84.1 98 85.2 108 93.1 87 91.6 346 88.9 Physician 41 77.4 82 83.7 98 90.7 82 94.3 303 87.6 Page 9 of 10
Advanced Practice Nurse 35 66.0 74 75.5 70 64.8 76 87.4 255 73.7 Registered Nurse 21 39.6 43 43.9 56 51.9 37 42.5 157 45.4 Social Worker 20 37.7 35 35.7 45 41.7 41 47.1 141 40.8 Chaplain 12 22.6 24 24.5 38 35.2 28 32.2 102 29.5 Palliative Care Team Meetings 55 87.3 108 93.9 113 97.4 89 93.7 365 93.8 Full team meets at least once a week 30 54.5 66 61.1 73 64.6 65 73.0 234 64.1 Full team meets every other week 2 3.6 1 0.9 1 0.9 6 6.7 10 2.7 Meetings are scheduled weekly, but not all team members attend 6 10.9 18 16.7 10 8.8 10 11.2 44 12.1 Meetings are scheduled every other week, but not all team members attend 2 3.6 2 1.9 7 6.2 3 3.4 14 3.8 Meetings are scheduled as needed on a case-by-case basis 6 10.9 12 11.1 12 10.6 4 4.5 34 9.3 No formal meeting schedule 9 16.4 9 8.3 10 8.8 1 1.1 29 7.9 Palliative Care Program Coverage 60 95.2 111 96.5 113 97.4 91 95.8 375 96.4 Provides 24/7 coverage 26 43.3 45 40.5 48 42.5 54 59.3 173 46.1 Not available 24/7 34 56.7 66 59.5 65 57.5 37 40.7 202 53.9 STAFF RECRUITMENT Staffing Stability 58 92.1 110 95.7 112 96.6 92 96.8 372 95.6 Stable - not recruiting or hiring 22 37.9 41 37.3 30 26.8 15 16.3 108 29.0 Reduced staff in past two years - not currently recruiting 2 3.4 11 10.0 9 8.0 4 4.3 26 7.0 Requesting/Recruiting additional staff 34 58.6 58 52.7 73 65.2 73 79.3 238 64.0 Recruitment Type 32 50.8 57 49.6 71 61.2 69 72.6 229 58.9 Recruiting clinical staff 22 68.8 41 71.9 51 71.8 61 88.4 175 76.4 Recruiting non-clinical staff 6 18.8 5 8.8 11 15.5 9 13.0 31 13.5 Requesting new staff lines for clinical staff 10 31.3 19 33.3 21 29.6 24 34.8 74 32.3 Requesting new staff lines for non-clinical staff 0 0.0 6 10.5 6 8.5 9 13.0 21 9.2 FUNDING Program Funding (Mean %) 48 76.2 91 79.1 94 81.0 73 76.8 306 78.7 Ongoing Hospital Support -- 70.4 -- 65.9 -- 64.1 -- 69.9 -- 67.0 Billing -- 26.3 -- 23.3 -- 24.0 -- 22.9 -- 23.9 Philanthropy/Foundations/Grants -- 0.9 -- 5.5 -- 2.8 -- 1.5 -- 3.0 Hospice Contracts -- 0.0 -- 0.6 -- 0.4 -- 1.4 -- 0.6 Stipends -- 0.0 -- 0.6 -- 0.4 -- 1.4 -- 0.6 Home Care Agency -- 0.0 -- 0.2 -- 0.0 -- 0.0 -- 0.1 Not Funded -- 0.0 -- 1.2 -- 1.3 -- 0.0 -- 0.7 Other -- 2.1 -- 2.1 -- 6.8 -- 2.7 -- 3.7 100% Hospital Support 23 53.5 37 46.8 33 39.3 29 43.3 122 44.7 Page 10 of 10