Palliative Care and the ED, an Impact Assessment
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Authors
H Young
A Moffat PA
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Issue Date
2025
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Abstract
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Abstract
The “Pallitrigger” tool was developed to support early identification of patients likely to be in their last year of life within Emergency Departments (ED), enabling timely palliative care intervention. Existing tools lacked sufficient accuracy and usability; Pallitrigger aimed to address this by offering a simplified, clinically relevant trigger system. During a 10-week study, 123 patients were screened, with 69 receiving face to face specialist palliative care input and the remainder, virtual assessment. Among patients flagged by the tool, 66% died within 12 months, demonstrating strong predictive value. Key triggers included disease progression, declining performance status, and frailty (CFS ≥7), all of which correlated strongly with one-year mortality. Implementation led to improved referrals, reduced length of stay (9days), earlier community planning, and reduced hospital admissions compared to our usual referral route. Importantly, Pallitrigger promotes equity by standardising identification based on clinical criteria, reducing reliance on subjective judgement. The tool supports a more consistent and equitable approach to end-of-life care and has the potential to reduce healthcare inequalities while enhancing patient-centred outcomes. Further evaluation and academic dissemination are planned.
References
Young H, Gannon JO-12 Use of a novel trigger tool for the identification and referral of patients in the last year of life – pallitriggerBMJ Supportive & Palliative Care 2022;12:A5
Moffat A, Young H18 Palliative medicine at the front door, an impact assessmentBMJ Supportive & Palliative Care 2024;14:A8.
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CLINICAL SERVICE/SERVICE IMPROVEMENT PODIUM PRESENTATION WINNER (2025)