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Developing triggers for the surgical intensive care unit for palliative care integration
Mark Finkelstein1, Nathan E Goldstein2, Jay R Horton3
1Icahn School of Medicine at Mount Sinai, New York, NY.
Journal of Critical Care
|August 3, 2016
Summary
Implementing palliative care triggers in surgical intensive care units (SICUs) can identify patients needing specialized consultations. This model aids in integrating palliative care into critical care settings for better patient outcomes.
Area of Science:
- Critical Care Medicine
- Palliative Care
- Surgical Care
Background:
- Palliative care is crucial for serious illnesses but underutilized in surgical critical care.
- Integration models are needed to improve access to palliative care in Surgical Intensive Care Units (SICUs).
Purpose of the Study:
- To evaluate a palliative care trigger model for identifying suitable patients in the SICU.
- To assess the effectiveness of specific triggers in facilitating palliative care consultations.
Main Methods:
- Prospective cohort study over 9 months in a tertiary medical center's SICU.
- Implementation and analysis of a new set of palliative care triggers.
- Analysis of 492 SICU admissions to identify factors associated with outcomes.
Main Results:
- Identified factors significantly associated with hospital death or hospice discharge.
- Key predictors included repeat SICU admission, advanced cancer, and physician referrals.
- The trigger system demonstrated potential in identifying patients for palliative care.
Conclusions:
- A structured trigger system can effectively identify patients who would benefit from palliative care.
- This approach facilitates the integration of palliative care services within intensive care settings.
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