The National Emergency and Palliative Medicine Initiative (NEPMI) strives to bring together emergency medicine and palliative care teams in the ER to improve end of life care for patients across the country.

Why emergency medicine and palliative care?

Working together, these two specialties have the ability to develop much needed education, processes and protocols that fosters goals of care conversations and primary palliative care medicine being initiated more often in the emergency department (ED). When this happens, we will see a profound shift of unwanted and resource-consuming care move away from acute critical care situations and instead see focused and goal concordant end of life care getting initiated earlier in the continuum of death.

Why emergency medicine?

Across the United States, the ED continues to be the primary source of emergent critical care for patients with acute and chronic terminal illness as well as the primary portal of entry for all hospital and ICU admissions.

NEPMI will provide primary palliative care education

We will serve as a “convener” for practitioners and health systems to promote and mobilize best practices, research and primary palliative care education across the United States.

Did you know that emergency departments are the primary portal of hospital entry for end-of-life care?


  • 50% of older adults will visit the ED in the last month of their lives
  • 10 million adults aged 75 and older visit the ED yearly
  • Adults 65 and older have the highest ED utilization compared to any other age group


NEPMI outreach and goals

  • Strengthen and create new national, regional and local collaborations with EM and PM organizations
  • Maximize multidisciplinary and multi-specialty perspectives and engagement
  • Leveraging technology and telemedicine to coordinate earlier access to palliative care in the ED
  • Promoting early goals of care conversations and utilization of advance directives, POLST, and living wills in the ED
  • Engaging and leading the national EMPM research agenda
  • Creating and supporting new ED palliative care screening and referral initiatives
  • Creating a C&C EMPM resource hub with valuable tools and playbooks
  • Building awareness around this unique opportunity to improve end of life care