A Literature Review on Care at the End-of-Life in the Emergency Department

The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In additi...

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Main Authors: Roberto Forero, Geoff McDonnell, Blanca Gallego, Sally McCarthy, Mohammed Mohsin, Chris Shanley, Frank Formby, Ken Hillman
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Emergency Medicine International
Online Access:http://dx.doi.org/10.1155/2012/486516
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author Roberto Forero
Geoff McDonnell
Blanca Gallego
Sally McCarthy
Mohammed Mohsin
Chris Shanley
Frank Formby
Ken Hillman
author_facet Roberto Forero
Geoff McDonnell
Blanca Gallego
Sally McCarthy
Mohammed Mohsin
Chris Shanley
Frank Formby
Ken Hillman
author_sort Roberto Forero
collection DOAJ
description The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and/or suboptimal policy implementation. These include uncertainty of treatment in the emergency department; quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.
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series Emergency Medicine International
spelling doaj-art-8f498c500b53430fa3a01598ebd51ebd2025-08-20T02:09:21ZengWileyEmergency Medicine International2090-28402090-28592012-01-01201210.1155/2012/486516486516A Literature Review on Care at the End-of-Life in the Emergency DepartmentRoberto Forero0Geoff McDonnell1Blanca Gallego2Sally McCarthy3Mohammed Mohsin4Chris Shanley5Frank Formby6Ken Hillman7Simpson Centre for Health Services Research, South Western Sydney Clinical School (Liverpool Hospital) and The Australian Institute of Health Innovation (AIHI), University of New South Wales, Level 1, AGSM Building (G27), Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, AustraliaCentre for Health Informatics, The Australian Institute of Health Innovation (AIHI), University of New South Wales, Level 1, AGSM Building (G27), Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, AustraliaCentre for Health Informatics, The Australian Institute of Health Innovation (AIHI), University of New South Wales, Level 1, AGSM Building (G27), Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, AustraliaEmergency Care Institute, NSW Agency for Clinical Innovation, Tower A, Level 15, Zenith Centre, 821-843 Pacific Highway, Chatswood, NSW 2067, AustraliaClinical Excellence Commission of New South Wales, Locked Bag A4062, Sydney South, NSW 1235, AustraliaAged Care Research Unit, South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Level 2, 2-4 Speed Street, Liverpool, NSW 2170, AustraliaPalliative Care Services, Illawarra Shoalhaven Local Health District, David Berry Hospital, 85 Tannery Road, Berry, NSW 2535, AustraliaSimpson Centre for Health Services Research, South Western Sydney Clinical School (Liverpool Hospital) and The Australian Institute of Health Innovation (AIHI), University of New South Wales, Level 1, AGSM Building (G27), Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, AustraliaThe hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and/or suboptimal policy implementation. These include uncertainty of treatment in the emergency department; quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.http://dx.doi.org/10.1155/2012/486516
spellingShingle Roberto Forero
Geoff McDonnell
Blanca Gallego
Sally McCarthy
Mohammed Mohsin
Chris Shanley
Frank Formby
Ken Hillman
A Literature Review on Care at the End-of-Life in the Emergency Department
Emergency Medicine International
title A Literature Review on Care at the End-of-Life in the Emergency Department
title_full A Literature Review on Care at the End-of-Life in the Emergency Department
title_fullStr A Literature Review on Care at the End-of-Life in the Emergency Department
title_full_unstemmed A Literature Review on Care at the End-of-Life in the Emergency Department
title_short A Literature Review on Care at the End-of-Life in the Emergency Department
title_sort literature review on care at the end of life in the emergency department
url http://dx.doi.org/10.1155/2012/486516
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