For Referring Physicians

Palliative Care Program

Additional Information for Physicians

Consult requests can be initiated directly in the computer or by contacting the Palliative Care team. Beeper (732) 437-3670 or Extension 5717.

Palliative care is a medical specialty that supports the primary care physician's care of patients with serious and life-threatening illness. Palliative care is not in place of curative care.

Why the need for palliative care now?

Palliative care is in greater demand because it addresses stronger emphasis on quality of care and the stresses placed on the medical system from the growing aging population.

How can palliative care help the attending physician?

Physicians with seriously ill patients who require complex pain and symptom management or have a high demand for patient/family communication can refer to palliative care specialists. Palliative care programs offer attending physicians:

Time
Expertise
Support
Satisfied patients

What patients are suitable for a palliative care consult?

General Referral Criteria (one or more of the following):

Frequent hospitalizations for same diagnosis
Difficult to control physical or emotional symptoms related to serious medical illness
Uncertainty regarding prognosis, goals of care
Patient or family requests for futile care or physician request for information regarding hospice appropriateness
DNR order conflicts
Limited social support and a serious illness (e.g. homeless, chronic mental illness)

Intensive Care Unit Referral Criteria

Admission from a nursing home in the setting of one or more chronic life-limiting conditions (e.g. dementia)
Two or more ICU admissions within the same hospitalization
Prolonged or difficult ventilator withdrawal
Multi-organ failure
Consideration of ventilator withdrawal with expected death
Metastatic cancer
Anoxic encephalopathy
Family distress impairing surrogate decision-making

Oncology Referral Criteria

Metastatic or locally advanced cancer progressing despite systemic treatments and functional decline
- Karnofsky < 50 or ECOG > 3
- Failure of appropriate/salvage chemotherapy
- Uncontrolled pain

Emergency Department Referral Criteria

Multiple recent prior hospitalization with same symptoms/problems
Long-term care patient with Do Not Resuscitate (DNR) and/or Comfort Care (CC) orders
Consideration of ICU admission and or mechanical ventilation in a patient
- with metastatic cancer and declining function
- with moderate to severe dementia
- with one or more chronic diseases and poor functional status at baseline

Consult Requests

Consult Requests can be initiated directly in the computer or by contacting the Palliative Care team. Beeper (732) 437-3670 or Extension 5717.

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