Schwartz/Reisman Emergency Medicine Institute

End-of-Life Care Study

End-of-Life Care in the ED

Patients with advanced and end-stage disease in need of symptom management and pain relief often present to the emergency department (ED). Previous research focusing on patients who were at the end-of-life found that these patients often did not receive the care they anticipated in the ED. Once in the acute care setting, the patient’s objectives and goals may be in direct contrast to the ED strategies of life-prolonging treatment. 70% of hospitalized Canadian elderly patients reported wanting to focus on providing comfort rather than life-prolonging treatment, but 54% of these patients were admitted to intensive care units at the end of life. Providers of emergency care have a unique opportunity to support palliative care interventions, but some ED professionals may not identify palliative care within their scope of practice and/or may question the appropriateness of providing this care in the ED.

Lead by SREMI post-doctoral research fellow, Anastasia Tobin, SREMI investigators will collaborate with our palliative care colleagues on a mixed-methodology project to explore how end-of-life care is provided in the ED from various perspectives; including patient, family and provider views. Our goal is to conduct a high quality, rigorous study using qualitative methods to develop a rich understanding of the experiences and processes of care in the ED, and to promote awareness of key issues requiring attention. From this research, we hope to develop evidence-based strategies for education and practice to improve the quality of end-of-life care in the ED.