Integrating Palliative Care Screening in the Intensive Care Unit: A Quality Improvement Project.

Area of Science:

• Critical care medicine
• Palliative care
• Quality improvement in healthcare

Background:

• Intensive care unit (ICU) patients face high mortality and recurrent hospitalization risks.
• Delayed palliative care access can lead to unaddressed symptoms and preventable admissions.
• A standardized method for assessing palliative care needs in ICUs is currently lacking.

Purpose of the Study:

• To enhance palliative care access for ICU patients.
• To improve the efficiency and reach of palliative care consultations.
• To address the identified need for a better palliative care process in critical care settings.

Main Methods:

• A quality improvement project utilized the Plan-Do-Study-Act model.
• A novel palliative care screening tool with clinical indicators was developed for nurses.
• Automated referrals for palliative care consultation were implemented for patients with positive screening scores.

Main Results:

• The screening tool identified 59 (22%) patients needing palliative care, significantly more than the traditional method (31, 11.6%).
• Patients identified without the tool experienced a mean delay of 6 days until consultation.
• Early identification through screening improved consultation efficiency.

Conclusions:

• The palliative care screening process facilitates early patient identification.
• This leads to improved consultation efficiency and maximized palliative care service benefits.
• The screening approach can decrease critical care resource utilization and reduce readmission rates.