Psychosocial Screening by Inpatient Palliative Care Teams: Patient Characteristics and Outcomes

Abstract

Context: Palliative care (PC) teams are structured as interprofessional so that patient and caregiver distress can be assessed and treated across all bio-psychosocial-spiritual-cultural domains. The National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care call for all PC team members to be competent at screening patients for psychosocial needs so that urgent referrals can be appropriately triaged to a PC social worker for follow-up assessment and intervention. Objectives: To understand patient characteristics and PC outcomes of hospitalized patients who are screened for psychosocial needs and subsequently receive psychosocial interventions during inpatient PC consultation. Methods: We analyzed data from 44,586 inpatient palliative care consultations by 11 Palliative Care Quality Network (PCQN) teams across various states between 01/01/2017 and 12/31/2021. Results: Overall, 81.5% (n = 36,332) of consults included a screen for psychosocial needs. Of those patients with an identified psychosocial need, (n = 25,661), 91.6% (n = 23,503) received a psychosocial intervention. Patients who spoke Spanish were less likely to receive a psychosocial screen than English-speaking patients (OR = 0.62, CI = 0.54-0.71). Patients who screened positive for a psychosocial need and identified as Hispanic/Latinx were less likely than those who identified as White to receive a follow-up psychosocial intervention (OR = 0.68, 95% CI = 0.57-0.80). Conclusion: 4 out of 5 patients were screened for psychosocial needs. When a psychosocial need was identified, the majority of patients received a follow-up psychosocial intervention. There was disparate delivery of psychosocial care for patients who identify as Hispanic/Latinx and/or Spanish-speaking, indicating a key area for improvement and further exploration.