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

TitleThe Creation of a Psychiatry-Palliative Care Liaison Team: Using Psychiatrists to Extend Palliative Care Delivery and Access During the COVID-19 Crisis.
Publication TypeJournal Article
Year of Publication2020
AuthorsShalev D, Nakagawa S, Stroeh OM, Arbuckle MR, Rendleman R, Blinderman CD, Shapiro PA
JournalJ Pain Symptom Manage
Volume60
Issue3
Paginatione12-e16
Date Published2020 Sep
ISSN1873-6513
KeywordsBetacoronavirus, Coronavirus Infections, COVID-19, Delivery of Health Care, Humans, Palliative Care, Pandemics, Patient Care Team, Pneumonia, Viral, Psychiatry, Psychotherapy, SARS-CoV-2
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.

DOI10.1016/j.jpainsymman.2020.06.009
Alternate JournalJ Pain Symptom Manage
PubMed ID32544648
PubMed Central IDPMC7293533