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considerable RN coordination of care for clinic workflows. Conversations averaged 30 minutes, and completion of documents happened more frequently within the inpatient than ambulatory setting. Thirty patients died since completion of the pilot, of which 40% (n¼12) had accepted HC and had completed advance plans. Compared to the non-HC group, the HC group was more likely to spend their final days in hospice care (91.7% vs. 55.6%, p¼0.199). Conclusions. HC provides a mechanism for culture change around ACP with substantial impact on patients and providers. Our pilot suggests implementation is feasible yet requires considerable change in workflows and resource allocation. Patients who completed HC were more likely to have a location of death consistent with expressed wishes.

attendees to gain confidence in a solid approach to the management of delirium despite conflicting research results. The session will 1) Hone skills regarding identification of reversible causes of delirium. 2) Review current strategies regarding pharmacologic (and non-pharmacologic management) of delirium in the palliative care setting, weighing the risks and benefits of each approach. 3) Examine treatment approaches for patients with persistent delirium despite first line neuroleptics. Treatment strategies to be covered included neuroleptic dose escalation, neuroleptic rotation, combination therapies (e.g. addition of a benzodiazepine or another agent). We will conclude this session with 10e15 minutes of questions from the audience. ObjectivesIdentify common language and word choice taught in healthcare settings to raise consciousness about the influence of words, metaphors and phrases. Use palliative patient videos and chart notes to help participants identify their unconscious bias. Describe pilot data to introduce language and word choice alternatives in medical education. As hospice and palliative care (HPC) proliferates across disciplines, so do language and phrases uniquely infused into palliative care parlance, education, practice, and documentation. While much attention is focused on delivering ''bad'' news and communication strategies, less attention is paid to word choice which is fundamental to communication. Beyond the specialty of HPC, clinicians across health care settings make word choices that have attributed meanings and unintended consequences that directly affect patient and family care. Consider multiple interpretations of the term ''palliative chemotherapy.'' Consider the evolution of the term ''physician-assisted suicide'' to ''physician-assisted death'' or ''physician aid in dying.'' What have been linguistic, cultural, and clinical forces and consequences behind these word choices? This session aims to raise consciousness, to consider both conscious and unconscious biases expressed by our words, and to highlight unintended consequences of written and spoken words. A brief review of language and word choices commonly taught and employed in health caredwith a focus on HPC settingsdsets the stage to engage participants through open dialogue and audience response technology about their own clinical experiences regarding language and word choice. Actual palliative patient videos will generate participant brainstorming of clinician unconscious biases in word choice. Shared palliative patient clinical documentation examples turn participant attention to the power of electronic health records as both instigator and corrective agent of ''chart lore.'' Finally, using institutional pilot data implementing word choice culture change through medical education initiatives, we will introduce concrete strategies for participants to raise clinical language awareness, implement related education, and trigger culture change at their respective institutions.

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Evaluate the impact that the palliative care team could have on the care of these patients. Research Objectives. To describe clinical and healthcare utilization outcomes for patients who underwent hypothermia protocol following cardiac arrest and did or did not receive palliative care consultation. Methods. We identified patients admitted to a critical care unit between 2006 and 2012 who had undergone hypothermia protocol in the setting of a cardiac arrest. Results. Reviewed the charts of 62 patients who underwent hypothermia protocol following cardiac arrest, of which 35 (56%) received a palliative care consultation. Twenty-one patients (34%) survived, of which only eight (13%) had a good neurological outcome. Twenty-six (74%) of the patients seen by palliative care died (22 in the hospital, 13 after palliative extubation, four in hospice). Fifteen (56%) of those patients without a palliative consultation died in the hospital, three after palliative extubation; none died in hospice. The mean hospital length of stay was 16.71 days for patients seen by palliative care and 17.1 days for patients not seen (p¼ 0.90). Mean ICU length of stay for patients seen by palliative care was 11.34 days compared with 12.59 days for patients not seen (p 0.55). Among patients who died in the hospital, the mean length of stay was 13.40 days for patients seen by palliative care compared with 8.87 days for those not seen (p 0.06). Mean ICU length of stay among those that died in the hospital was 10.72 days for those seen by palliative care compared with 8.73 for those not seen(p 0.35). Conclusion. Palliative care consultation for patients with hypothermia protocol results in increased rates of deaths on hospice. Palliative care consultation may be associated with a lower mean ICU and hospital length of stay, however, the study was underpowered to detect a difference.