Do patients die well in your emergency department?

Objectives: Although the role of the ED in the management of patients needing palliative care is recognised internationally, there are little Australasian data on this issue. This study aimed to determine the current knowledge and attitude to the provision of palliative care in Australasian EDs. Methods: All ED directors in Australasia were invited to complete an online survey about the provision of palliative care in their department. Quantitative data were described using counts and proportions, and qualitative data were summarised thematically. Results: Of 165 eligible ED directors, 35 completed the survey (22%; 95% CI, 15-28%). Only 17/35 (49%; 95% CI, 32-65%) believed that ED provided good palliative care, and 28/35 (80%; 95% CI, 67-93%) were unaware of international gold standard palliative care protocols. Most had access to hospital-based palliative care specialists 27/35 (77%; 95% CI, 63-91%); however, only 5/27 (19%; 95% CI, 4-33%) used them. Few EDs undertake formal training in palliative care 10/35 (29%; 95% CI, 16-45%). Respondents showed concern about the quality of palliative care they provide and advocated for more palliative care training. Conclusion: Although limited by the low response rate, this survey indicates that there is a need and a desire for greater integration of the values and standards of high-quality palliative care in Australasian EDs.