"Cancer patients admitted to the hospital with advanced stages of disease who were referred early to palliative care had decreased health care utilization and increased use of support services following discharge according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai. Published today in the Journal of Oncology Practice the study also determined that a systemized process of referrals resulted in significant improvements in day readmission rates hospice referral and receipt of chemotherapy after discharge in patients with advanced cancers. This is the first study to demonstrate that among advanced cancer patients admitted to an inpatient oncology service standardized use of triggers for palliative care consultation is associated with substantial improvement on multiple quality measures. Patients with advanced cancers often have significant symptoms that affect their emotional status quality of life and functional ability. The integration of palliative care improves symptom control and decreases unwanted health care use yet many patients are never offered these services.  As cancer progresses patients are often at high risk for physical pain and emotional distress said Cardinale B. Smith MD MSCR Associate Professor of Medicine Hematology and Medical Oncology and of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. Health care utilization is extremely high once cancer progresses with hospital readmission rates as high as  percent and death in the acute care setting ranging from  percent  both measures of poorquality cancer care. To improve the quality of care researchers at the Icahn School of Medicine developed standardized criteria or triggers for palliative care consultation for patients admitted to the cancer unit at The Mount Sinai Hospital. Patients were eligible for this prospective cohort study if they met one or more eligibility criteria advanced solid tumor cancer prior hospitalization within  days hospitalization for more than  days or active symptoms.  Care for patients with advanced cancer is often characterized by time spent on acutecare hospital wards and intensive care units or receiving invasive procedures chemotherapy infusions and radiographic imaging. Such interventions drive escalating costs and are often directly in conflict with patients prior stated wishes said Dr. Smith.  Consultation with the palliative care team included establishment of goals of care advance care plans using standardized communication protocols transition planning and symptom assessment and treatment using the Edmonton Symptom Assessment Scale ESAS. The palliative team was composed of one board certified PC physician one nurse practitioner one social worker a chaplain and one to two trainees.  Our results highlight the need to adopt this practice at acute care hospitals across the nation said Dr. Smith. Palliative care involvement helps patients understand their prognosis establish goals of care and formulate discharge plans in line with those goals and this study is the first to confirm the impact of using standardized criteria and automatic palliative care consultation on quality of cancer care. Coauthors of the study include Kerin Adelson MD Division of HematologyOncology at Yale University School of Medicine.  About the Mount Sinai Health SystemThe Mount Sinai Health System is an integrated health system committed to providing distinguished care conducting transformative research and advancing biomedical education. Structured around seven hospital campuses and a single medical school the Health System has an extensive ambulatory network and a range of inpatient and outpatient servicesfrom communitybased facilities to tertiary and quaternary care. The System includes approximately  primary and specialty care physicians  jointventure ambulatory surgery centers more than  ambulatory practices throughout the five boroughs of New York City Westchester Long Island and Florida and  affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the Honor Roll of best hospitals in America ranked No.  nationally in the  Best Hospitals issue of U.S. News  World Report. The Mount Sinai Hospital is also ranked as one of the nations top  hospitals in Geriatrics GastroenterologyGI Surgery CardiologyHeart Surgery DiabetesEndocrinology Nephrology NeurologyNeurosurgery and Ear Nose  Throat and is in the top  in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No.  nationally for Ophthalmology while Mount Sinai Beth Israel Mount Sinai St. Lukes and Mount Sinai West are ranked regionally. Mount Sinais Kravis Childrens Hospital is ranked in seven out of ten pediatric specialties by U.S. News  World Report in Best Childrens Hospitals. For more information visit http or find Mount Sinai on Facebook Twitter and YouTube."