Objective To evaluate a new intervention intended to increase referral rates from the emergency department (ED) to the palliative medicine service (PMS) in acute hospitals. Methods We conducted a quasi-experimental evaluation in an urban teaching hospital in Dublin, Ireland. Data were collected over two eight-week periods in November/December 2013 and May/June 2015, with the PALliative Medicine in the Emergency Department (PAL.M.ED.™) intervention implemented in the intervening period. All adults who were admitted to the hospital via the ED during the two time periods and who received a palliative care consultation during their hospital stay were included in the study. Our primary analysis evaluated the impact of PAL.M.ED.™ on PMS referral in the ED. Our secondary analysis evaluated the impact of PMS referral in the ED on length of stay (LOS) and utilization, compared to PMS referral later in the admission. We controlled for observed confounding between groups using propensity scores. Results PAL.M.ED.™ was associated with an increase in PMS referral in the ED ( p < 0.005; odds ratio: 10.5 (95%CI: 3.8 to 28.7)). PMS referral in the ED was associated with shorter hospital LOS ( p < 0.005; −10.9 days (95%CI: −17.7 to −4.1)). Conclusions Low PMS referral rates in the ED, and the poor outcomes for patients and hospitals that arise from admissions of those with serious illness, may be mitigated by a proactive intervention to identify appropriate patients at admission.

All submissions must be submitted online as word documents. Text should be one and a half spaced on one side of A4 paper with 20mm margins on all edges. Font = Times New Roman, 11 point for all text and all headings must be clearly defined. Only the first page of the article should bear the title, the name(s) of the author(s) and the address to which reviews should be sent. In order to enable 'blind' refereeing, please do not include author(s) names on running heads. All illustrations, figures, and tables are placed within the text at the appropriate points, rather than at the end. Foot/End Notes These should be avoided where possible; the journal preference is for footnotes rather than endnotes. Referencing References must be useful, targeted and appropriate. The Editorial preference is APA style; see Publication Manual of the American Psychological Association (Sixth Edition). Please check all citations in the article are included in your references list, if in reference list they are cited in document, and formatted in the correct APA style. All doi numbers must be added to all references where required.

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Increasingly, New Zealand primary and intermediate schools are adopting the concept of flexible learning spaces and promoting team teaching approaches. Such open spaces and pedagogy can be challenging for even experienced teachers to adapt to. Is it realistic, therefore, to expect novices to work successfully in these challenging spaces from the onset of their teaching careers? Initial Teacher Education (ITE) programmes in New Zealand equip graduates with the knowledge and skills to plan, teach and evaluate learning for a diverse class of children with individual learning, social and cultural needs. However, while researching their own practice working within new spaces and pedagogy, some experienced Bay of Plenty intermediate and primary teachers articulated additional necessities for beginning teachers starting out in such complex teaching environments. Analysis of their ideas suggests such spaces require teachers to have particular capabilities if they are to work collaboratively in open learning spaces. This paper argues that ITE programmes and leaders need to be proactive and include appropriate theoretical and pragmatic coursework, to assist student teachers to cultivate the capabilities required of collaborative team members, by the time they graduate.

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