Table 1

Description of intervention components

Intervention component	Actors	Target	Timing	Dose
Education in Palliative and End-of-Life Emergency Medicine	All full-time emergency physicians, nurse practitioners and physician assistants.	Primary palliative care knowledge and skills in needs assessment and referral.	Once during 3-week intervention period.	1-hour online didactic course.
EM Talk	All full-time emergency physicians, nurse practitioners and physician assistants.	Simulation workshop in end-of-life communication.	In-person during 3-week intervention period.	4-hour in-person simulation workshop.
End of Life Nursing Education Consortium Critical Care	All full-time emergency medicine nurses.	Primary palliative care knowledge and skills in needs assessment and referral.	Once during 3-week intervention period.	1-hour online didactic course.
CDS system	All emergency providers.	Alerts and new workflow to refer to palliative care, home care and hospice services.	Go live during intervention period.	Continued use throughout study period and beyond.
Audit and feedback	All emergency providers.	Individualised report of number of referrals to palliative care, home care and hospice services.	First report delivered in intervention period then tailored accordingly.	Weekly report during intervention period then incorporated into ED-specific continuous quality improvement process.