Vol. 41 No. 1 January 2011 307Schedule with Abstracts

times a week, and if a patient met criteria, sug-gested ordering a consult. Cards were distrib-uted to staff with criteria for PC consult. Aretrospective chart review was performed fora historical comparison.Results. Palliative care consults in the ICU in-creased from 28 in 2008 to 63 in 2009, a 125%increase. In addition the number of ICU deathswith a PC consult increased from 12% in 2008 to31.7% in 2009. Family satisfaction scores in theICU increased from an overall score of 52% be-fore the study to 77% during the study and 82%after the study was completed. ICU length of stay(LOS) decreased significantly during study com-pared to prior. Hospital LOS decreased for thosereceiving PC consults.Conclusion. Palliative care participation in mul-tidisciplinary ICU rounds combined with selec-tive screening criteria increased palliative careconsults, improved family satisfaction, and de-creased length of stay. This effect was sustainablepost intervention.Implications for research, policy, or practice. Asocial work screener in the ICU can effectivelyincrease consults, improve family satisfaction,and decrease ICU and hospital LOS. Future di-rections include applying this intervention inthe surgical ICU and emergency department.

Primary Care Physician Knowledge,Utilization, and Attitude RegardingAdvance Care Planning, Hospice, andPalliative Care: Much Work Remains (757)Sara Snyder, DO, Summa Health System, Akron,OH. Kyle Allen, DO AGSF, Summa Health Sys-tem, Akron, OH. Susan Hazelett, MS RN,Summa Health System, Akron, OH. Steven Rad-wany, MD, Summa Health System, Akron, OH.(All speakers have disclosed no relevant finan-cial relationships with the following exception:Allen is the co-owner and inventor and receivesrevenue and patent rights from BoomerCareTechnologies.)

Objectives1. Identify barriers that primary care physicians

face with advance care planning.2. Recognize that physician knowledge of the

terms palliative care and hospice are still poor,and community and primary care physicianeducation should be pursued in this area.

Background. Evidence has shown increased pa-tient/family satisfaction, decreased health care

utilization, and lower health care expenditureswhen advance care planning (ACP), palliativeand hospice care are used as an adjunct in pa-tient care. However, these services remainunderutilized.Research objectives. Evaluate primary care phy-sician (PCP) knowledge, attitudes, and utiliza-tion of ACP, palliative care, and hospice.Methods. Community, outpatient PCPs weremailed investigator-generated surveys.Results. 154 of 372 surveys were returned (41%).Of physicians surveyed, 28% felt that palliativecare and hospice are virtually the same, and21.7% indicated hospice referrals should pre-cede palliative care referrals. 95% of PCPs indi-cated they were comfortable discussing ACPwith their patients, yet only 43% indicated thatthey had these discussions with appropriate pa-tients. The more physicians believe ACP discus-sions are too upsetting the less comfortablethey are having these discussion (p ¼ .000)and the more likely they are to refer to hospice(p ¼ .042). There was a positive significant corre-lation between the level of physician comfortand (1) the percent of appropriate patientswith whom they have ACP discussions (p ¼.005), (2) the percent who experienced a clinicalsituation where they believed knowing ACP wish-es would have benefitted patient care (p ¼0.000) and (3) the percent who had ACP experi-ence with family or friends (p ¼ 0.013). Themore physicians believe ACP discussions aretoo time consuming the less likely they are tohave such discussions (p ¼ .016) or believethey benefit patient care (p ¼ 0.011).Conclusion. Physician experience with and un-derstanding of ACP, palliative care, and hospiceare insufficient to allow effective utilization ofthese modalities.Implications for research, policy, or practice. Ef-forts are needed to increase PCP education onthe appropriate utilization of ACP, palliativecare, and hospice. Research could investigatewhether activities such as personal advance di-rective completion by providers increases theACP discussions they have with patients.

Relationship Between Comorbidity Indexand Symptom Burden in Chronically IllOlder Adults (758)Noelle Stanley, MD, University of Texas HealthScience Center San Antonio, San Antonio, TX.Tarik Hadid, MD, West Pennsylvania Allegheny