Integrating Palliative Care into Emergency Medicine in Greece: A Novel Model Using ED-Based Palliative Care Hubs

Background: Palliative care is essential to quality of life for people with life-limiting illness and can strengthen health-system performance. In Greece, however, services remain fragmented—especially in emergency departments (EDs), which serve as safety nets yet lack structured training, pathways, and tools for end-of-life care. We propose the Hellenic Emergency Palliative Care Project (HelP CaPe): a pragmatic, government-sponsored, multicomponent intervention to integrate palliative care into two high-volume EDs (Nikaia General Hospital, Athens; Larissa General Hospital). Methods: HelP CaPe includes (1) culturally adapted education for emergency clinicians using the Education in Palliative and End-of-Life Care-Emergency Medicine curriculum; (2) ED-based palliative care hubs that deliver symptom relief, minor procedures, goals-of-care conversations, and family support; and (3) formal linkages to home- and community-based services to improve continuity. Design and implementation draw on comparable resource-constrained models, including Hospice Ethiopia, and align with Greek preferences for home-based care. Evaluation will track patient experience and utilization (avoidable admissions and repeat ED visits), clinical processes (analgesia and minor procedures), and clinician outcomes (satisfaction and burnout). Conclusion: Leveraging existing emergency medicine infrastructure, HelP CaPe addresses key gaps—limited training and absence of structured pathways—while building capacity for sustainable service delivery. The initiative aims to reduce unnecessary ED demand, enhance goal-concordant care, and relieve pressure on EDs, with potential wellness benefits for clinicians through diversified practice. If successful, HelP CaPe will offer a scalable model for integrating palliative care within EDs in Greece and other health systems facing similar constraints.