The Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis. Academic Article uri icon

Overview

abstract

  • CONTEXT: During the course of March and April 2020, New York City experienced a surge of a 170,000 coronavirus disease 2019 (COVID-19) cases, overwhelming hospital systems and leading to an unprecedented need for palliative care services. OBJECTIVES: To present a model for rapid palliative care workforce expansion under crisis conditions, using supervised advanced psychiatry trainees to provide primary palliative services in the acute care and emergency setting. METHODS: In response to the New York City COVID-19 surge, advanced psychiatry trainees at New York-Presbyterian Columbia University Irving Medical Center were rapidly trained and redeployed to a newly formed psychiatry-palliative care liaison team. Under the supervision of consultation-liaison psychiatrists (who also served as team coordinators), these trainees provided circumscribed palliative care services to patients and/or their families, including goals-of-care discussions and psychosocial support. Palliative care attendings remained available to all team members for more advanced and specialized supervision. RESULTS: The psychiatry-palliative care liaison team effectively provided palliative care services during the early phase and peak of New York City's COVID-19 crisis, managing up to 16 new cases per day and provided longitudinal follow-up, thereby enabling palliative care specialists to focus on providing services requiring specialist-level palliative care expertise. CONCLUSION: By training and supervising psychiatrists and advanced psychiatry trainees in specific palliative care roles, palliative care teams could more effectively meet markedly increased service needs of varying complexity during the COVID-19 crisis. As new geographic regions experience possible COVID-19 surges in the coming months, this may serve as a model for rapidly increasing palliative care workforce.

publication date

  • June 13, 2020

Research

keywords

  • Betacoronavirus
  • Coronavirus Infections
  • Delivery of Health Care
  • Palliative Care
  • Patient Care Team
  • Pneumonia, Viral
  • Psychiatry

Identity

PubMed Central ID

  • PMC7293533

Scopus Document Identifier

  • 85087035759

Digital Object Identifier (DOI)

  • 10.1016/j.psym.2020.02.002

PubMed ID

  • 32544648

Additional Document Info

volume

  • 60

issue

  • 3