End of Life Outside of "Business Hours": A Retrospective Review Evaluating Time of Death and Provider Time at End of Life

J Palliat Med. 2021 Sep;24(9):1379-1382. doi: 10.1089/jpm.2021.0127. Epub 2021 Jul 1.

Abstract

Introduction: Pediatric palliative care (PPC) benefits patients and families, while potentially creating emotional and resource-management burdens for providers. This study's purpose was to characterize the occurrence of deaths attended by PPC providers outside of "business hours." Methods:N = 786 PPC patients at a single center died between 2008 and 2015. Descriptive statistics were prepared for all variables (Wilcoxon rank-sum test for continuous; chi-square or Fisher's exact test for categorical). Results:N = 434 (55%) of deaths occurred outside of business hours; n = 332 (70%) were attended by PPC. Time spent attending a death was not significantly longer when other PPC providers were present but was when certain tasks were performed (coordination with medical examiner and memory making). Conclusion: The occurrence of the majority of deaths outside of business hours has significant implications for service delivery models, provider emotional health, and health care value.

Keywords: advance practice nurse; compassion fatigue; palliative care; pediatric; physician.

MeSH terms

  • Child
  • Death
  • Delivery of Health Care
  • Hospice and Palliative Care Nursing*
  • Humans
  • Palliative Care*
  • Retrospective Studies