Hospice is under-utilized, especially for non-cancer illness deaths. People from communities of color are less likely to receive hospice services. Identifying patients with terminal illnesses in the emergency department (ED) and initiating the hospice discussion or process could be one way to rectify this. Most patients have an ED visit within the last 6 months of life. This suggests that EDs are missing opportunities to offer hospice care to patients. When hospice is under consideration, many EDs admit patients to arrange hospice, but this is not necessary. Transition to hospice care can be coordinated out of the ED or ED observation unit (OU). Admission for hospice placement is rarely necessary, and in one ED study, 89% of ED patients qualifying for and wanting hospice had less than a 2-day stay. Creating an ED to hospice protocol for your OU could improve the provision of patient-oriented care and decrease strain on hospital resources by decreasing unnecessary admissions.