Primary Palliative Care for Emergency Medicine (PRIM-ER): Protocol for a Pragmatic Cluster-Randomised Stepped Wedge Design to Test the Effectiveness of Primary Palliative Care Education Training and Technical Support for Emergency Medicine

摘要

IntroductionEmergency departments (ED) care for society’s most vulnerable older adults who present with exacerbations of chronic disease at the end of life, yet the clinical paradigm focuses on treatment of acute pathologies. Palliative care interventions in the ED capture high-risk patients at a time of crisis and can dramatically improve patient-centred outcomes. This study aims to implement and evaluate Primary Palliative Care for Emergency Medicine (PRIM-ER) on ED disposition, healthcare utilisation and survival in older adults with serious illness.