The feasibility of an inpatient intervention to improve end-of-life care in gynecologic oncology patients.

69Background: Unscheduled hospitalizations in patients with advanced cancer predicts < 6 month median survival. Patients with cancer hospitalized near the end of life (EOL) often receive aggressive treatments without survival advantages and have poor quality-of-life. EOL discussions and palliative care (PC) services reduce aggressive care. Methods: An intervention was designed to decrease aggressive EOL care in Gynecologic Oncology (GO) inpatients at a high risk for death within 6 months. Inclusion criteria were advanced gynecologic cancer and 1 of the following: bowel obstruction, failure to thrive, dehydration, cancer-related pain, malignant pleural effusion or ascites, or PCN management. Patients were identified by the care team on admission. An independent auditor assessed if patients were appropriately identified. Eligible patients received a 3-part high risk Gynecologic Oncology (HR-GO) bundle: 1) PC consult, 2) goals of care (GOC) conversation ≤ 48 hours of admission, and 3) PC follow-up within 2 w...