为了改进老年急诊入院患者的血管壁姑息护理，我们开发了PalliSupport干预措施，包括教育计划和血管壁姑息护理路径。该护理路径包括及时确定姑息护理需求、预先护理计划、多学科团队会议、暖和转接和后续家访。本研究评估了实施血管壁姑息护理路径后患者相关结局和血管壁合作的变化。我们进行了前后对照研究，比较了实施前与实施后1）非计划入院和按预期地点死亡2）实施前、实施后6个月以内和6至18个月后的血管壁合作。荷兰一家教学医院于2017年2月至2020年2月间收集姑息护理团队会诊数据。姑息护理团队进行了711次初次会诊。实施后会诊次数以及非恶性疾病患者的会诊次数和预先护理计划的会诊次数增加。护理路径的实施对非计划住院没有显著影响，但与实施6个月以上期间的按预期地点死亡有正向关联（调整后 OR：2.12，95% CI：0.84-5.35，p值：0.11；调整后 OR：3.14，95% CI：1.49-6.62，p值：0.003）。对血管壁合作的影响表明，在实施期间有更多的暖和转接，但在长期内没有。初级保健专业人员在实施期间和实施后不久更常参加多学科团队会议，但在实施后6个月以上的时间内没有更多参加。此护理路径对非计划住院没有影响，但实施后有更多患者在他们所偏好的地点去世。护理路径的实施提高了对院内姑息护理的关注和认识，但在长期内没有改善血管壁合作。对于一些患者，住院可能有助于实现按预期地点去世。© 2023. 作者。

To improve transmural palliative care for older adults acutely admitted to hospital, the PalliSupport intervention, comprising an educational programme and transmural palliative care pathway, was developed. This care pathway involves timely identification of palliative care needs, advance care planning, multidisciplinary team meetings, warm handover, and follow-up home visits. With this study, we evaluate changes in patient-related outcomes and transmural collaboration after implementation of the care pathway.We conducted a before-after study, in which we compared 1) unplanned hospital admission and death at place of preference and 2) transmural collaboration before implementation, up to six months, and six to 18 months after implementation. Data from palliative care team consultations were collected between February 2017 and February 2020 in a teaching hospital in the Netherlands.The palliative care team held 711 first-time consultations. The number of consultation, as well as the number of consultations for patients with non-malignant diseases, and consultations for advance care planning increased after implementation. The implementation of the pathway had no statistically significant effect on unplanned hospitalization but associated positively with death at place of preference more than six months after implementation (during/shortly after adjusted OR: 2.12; 95% CI: 0.84-5.35; p-value: 0.11, long term after adjusted OR: 3.14; 95% CI: 1.49-6.62; p-value: 0.003). Effects on transmural collaboration showed that there were more warm handovers during/shortly after implementation, but not on long term. Primary care professionals attended multidisciplinary team meetings more often during and shortly after implementation, but did not more than six months after implementation.The pathway did not affect unplanned hospital admissions, but more patients died at their place of preference after implementation. Implementation of the pathway increased attention to- and awareness for in-hospital palliative care, but did not improve transmural collaboration on long-term. For some patients, the hospital admissions might helped in facilitating death at place of preference.© 2023. The Author(s).