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Hospital providers may have difficulty offering end-of-life prognosis

March 24, 2014
by Sandra Hoban, Managing Editor
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When medical professionals believe that no more can be done for a hospitalized patient, the time comes to recommend palliative care. A recent study published in the April issue of Palliative Medicine analyzed the results of a sample telephone survey of healthcare providers at a U.S. teaching medical center who requested palliative care consultations.

Of the 65 respondents, 45 (69.2%) reported that a prognosis discussion was held, whereas 15 (23.1%) reported that the discussion did not occur. When a prognosis discussion did take place, most providers said that all aspects of palliative care were covered except life expectancy, survival rates/statistics and psychosocial concerns.

Difficulty in determining prognosis, the perception that the patient already was aware of his or her prognosis and the belief that such a discussion was better suited for a different specialty were cited as reasons why a prognosis discussion did not occur.

Study analysts found that primary team providers in the academic hospital environment are uncomfortable with prognostication. In this hospital setting, healthcare teams are composed primarily of medical trainees and nurses who may not have had sufficient training, experience or confidence in handling this delicate issue.

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