Increasing Access to Palliative Care Services in the Intensive Care Unit

Area of Science:

• Critical Care Medicine
• Palliative Care
• Quality Improvement Science

Background:

• The Institute of Medicine emphasizes palliative care for end-of-life care.
• Approximately 20% of deaths occur after intensive care unit (ICU) admission.
• ICUs need systems to improve access to palliative care services.

Purpose of the Study:

• To develop and implement a palliative care screening tool in the ICU.
• Utilize evidence-based triggers to identify patients needing palliative care.
• Increase the proportion of palliative care consultations within the ICU.

Main Methods:

• A quality improvement project using the Plan-Do-Study-Act cycle in a medical-surgical ICU.
• Developed an evidence-based palliative care screening tool with interdisciplinary input.
• Compared palliative care consultation rates pre- and post-intervention.

Main Results:

• Palliative care consultations increased from 10% to 30% among patients admitted by the pulmonary critical care team.
• Demonstrated a promising increase in palliative care service utilization.
• Results align with evidence-based recommendations for end-of-life care.

Conclusions:

• An evidence-based screening tool can increase palliative care referrals in the ICU.
• Expansion to other medical subspecialists is recommended.
• Further assessment is needed to evaluate broader implementation impact.