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Despite efforts to improve access to palliative care services, a significant number of patients still have unmet needs throughout their continuum of care. As such, this project was conducted to increase recognition of patients who could benefit from palliative care, increase referrals, and connect regional sites. This study utilized Plan-Do-Study-Act cycles through a quality improvement approach to develop and test the Palliative Care Screening Tool and aimed to screen 100% of patients within 24 hours who were admitted to selected units by February 2017. The intervention was implemented in 3 different units, each within community hospitals. Patients 18 years or older were screened if they were admitted to one of the selected units for the project, regardless of their diagnosis, age, or comorbidities. The percentage of newly admitted patients who were screened and the total number of palliative care consults were assessed as outcome measures. The tool was met with varying compliance among the 3 sites. However, there was an overall increase in consults across all hospital sites, and an increase in the proportion of noncancer patients was demonstrated. Although the aim was not reached, the tool helped to create a shift in the demographic of patients identified as palliative.

A bit of background to set the stage, if you’ll indulge me. Growing up in West Bloomfield, Michigan, I was never overly ambitious, nor did I have any lofty academic goals. In particular, I never had any desire to go to law school or, for that matter, to become a lawyer. I come from a family of trial attorneys and it never interested me much. I was a numbers person and didn’t enjoy a lot of deep reading and essay writing (somewhat ironic as I’m writing this for a law journal). But when I started in public accounting and developed a strong interest in tax, I realized I could do much more with a law degree than only a CPA. At that point, with good but not great grades from Michigan undergraduate business school and good but not great LSAT scores, as well as a desire to go to law school in Michigan for cost reasons, I applied to Wayne State University Law School and was accepted. Much to my surprise, I really enjoyed law school and was very happy at Wayne. Also, I ended up with straight As and was tied for first in my class. It seemed like I had found my groove, so at that point, I decided I should apply to transfer to the University of Michigan Law School, and I was thrilled to be accepted. Straight off, I elected any tax and business courses that I could find. Which leads me, finally, to Professor Kahn. My first tax course was personal income tax with Professor Kahn. I was a bit intimidated, and for good reason. He had written numerous books that were essential to the study of tax law and he was somewhat of a legend in the history of the University of Michigan Law School. My best friend’s dad had Professor Kahn twenty plus years before I did, and I had heard a lot about him. As it turned out, Professor Kahn was also brilliant, funny and made what could be a dry topic very engaging. I remember the first time he called on me like it was yesterday. He seemed to like my thought process and my answer. It was a huge relief.