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provider. Insurance choices are confusing. Hospitals are intimidating. Being sick is scary. But when it
comes to the patient’s health, he is his own best advocate, so he needs to take charge.
Despite rapid proliferation of hospital-based palliative care consultation services (PCCS) across the
country, there is little description of the dynamic processes that the PCCS and the non-PCCS hospital
cultures experience during the institutionalization of a successful PCCS [1-4].
Although not all successful PCCSs look alike, one common marker of early success is solid and
consistent growth in the number of consultations. Using this criterion, the PCCS that we studied
represents a successful program.
Much of the infrastructure perceived by our participants as necessary for the success of the PCCS is
similar to elements previously identified by others, including a robust data collection process Others
key elements include the presence of top administrative advocacy, broad-based multidisciplinary
support, and a credible physician leader.