Nurse practitioner at Veteran's Administration Palo Alto in Palo Alto, CA Assistant professor at Valley Foundation School of Nursing, San Jose State University in San Jose, CA Research associate at the Center for Innovation to Implementation, VA Palo Alto Healthcare System in Palo Alto, CA Clinical assistant professor at the Division of General Medical Disciplines at Stanford School of Medicine in Stanford, CA Research health science specialist at the Center for Innovation to Implementation, VA Palo Alto Healthcare System Director of the Center for Innovation to Implementation, VA Palo Alto Healthcare System Investigator at the Center for Innovation to Implementation, VA Palo Alto Healthcare System and an assistant professor in the Division of General Medical Disciplines at Stanford School of Medicine in Stanford, CA
In order to enhance care for high-risk patients, many health systems are implementing intensive outpatient programs, often with advanced practice nurses taking the lead. We sought to examine the effects of 1 such nurse practitioner--led program on end-of-life care for patients in the Veterans Affairs health care system. Patients enrolled in the intensive program had higher rates of hospice referral (74%) compared with patients enrolled in standard primary care (44%) (P = .025). Nurse practitioner--led intensive outpatient primary care may increase hospice referrals for high-risk patients near end-of-life.