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UWHC Guidelines for Hospice Referrals

UWHC Guidelines for Hospice Referrals - Departments & Programs, UW Medical Foundation, Patient Resources, Social Work Services Quick Guide, Social Work Manual, Discharge Planning and Referrals, Hospice


Case Manager/Social Worker (CM/SW) will make initial contact to Palliative Care (PC) regarding all hospice referrals.*

PC will discuss with CM/SW and/or team to discern whether PC should meet with patient and family.

*When contacting, please provide:

Several issues have led the Palliative Care team to propose greater involvement with hospice-related needs throughout the hospital. Some issues apply to all patients and others are specific to those served by HospiceCare Inc., our Dane County provider. We believe we are missing opportunities to improve our care of patients at the end of life. By reviewing all hospice referrals, and assisting where appropriate, we hope to ensure that all patients and families are optimally prepared when they choose hospice services.

One area of concern is staffing availability. At a time when Palliative Care has more staff available for consultations, HCI liaisons have been stretched more tightly. Some patients and families have been referred to HCI even though they are not in the agency's service area or have not yet decided to stop life-prolonging treatments — likely because of familiarity with HCI and their strong customer service approach. While HCI is happy to respond to all referrals, it is neither the best use of their time nor the most efficient way to address those patients' needs.

The other primary area for improvement is with smooth transitions. Through discussions with the HCI Intake team, we have discover that they would benefit from more consistency with discharge plans across all inpatient services. While some discharges require minimal work on their behalf, others require more time to secure orders that are appropriate for hospice care (especially medications and code status). The Palliative Care team is skilled at addressing hospice-related issues and can help teams to make the appropriate preparations for transition to either HCI or agencies outside Bane County.

We also hope that indirect benefits of this protocol will be to increase palliative care awareness throughout the hospital, serve a greater number of patients and families, and do a better job of tracking how we serve patients and families at the end of life.

Updated 04/2005