192 Efficacy of a Novel Re-Training of Ophthalmology Residents as Palliative Care Extenders in the Emergency Department during the COVID-19 Surge

Study Objectives: During the COVID-19 surge in New York City, our hospital system put in place a 24-hour helpline to connect Emergency Department (ED) physicians to Palliative Care specialists During the surge of critically ill COVID-19 patients, there was concern that large volumes, high acuity, and the need to wear protective equipment, were barriers to ED physicians calling the helpline To address this concern, we placed ophthalmology residents in the ED from 8am to 11pm each day to act as palliative care extenders, helping connect ED physicians, Palliative Care physicians, patients and families Ophthalmology residents were chosen for this role due to their clinical expertise and availability after the cessation of elective surgeries during the state of emergency We sought to evaluate the number of palliative care connections made with this model Methods: We performed a retrospective review of admissions from the acute areas of our ED from April 6, 2020 to April 19, 2020 During the first week, only the 24-hour helpline was available During the second week, both the palliative care helpline and in-situ residents were available Number of palliative care notes from the ED were compared before and after the intervention Results: In the week when only the helpline was available, 443 ED visits occurred, of which 169 (38 1%) were admitted and 10 (5 9%) had palliative care notes written in the ED In the week when both the helpline and in-situ residents were available 464 ED visits occurred, of which 131 (30 0%) were admitted and 36 (27 4%) had palliative care notes written in the ED Conclusion: Compared to a helpline alone, in situ palliative care presence in the ED increased the opportunity for early palliative care intervention, as reflected by an increase in the number of palliative care notes written in the ED This model was an effective re-tasking of specialized health care practitioners from a specialty that was less strained by the pandemic to one that was under pressure