A Model for Increasing Palliative Care in the Intensive Care Unit: Enhancing Interprofessional Consultation Rates and Communication

作者：Villarreal Deborah^*; Restrepo Marcos I; Healy Jennifer; Howard Bonita; Tidwell Janet; Ross Jeanette; Hartronft Scotte; Jawad Marriyam; Sanchez Reilly Sandra; Reed Kristin; Espinoza Sara E

来源：Journal of Pain and Symptom Management, 2011, 42(5): 676-679.

DOI：10.1016/j.jpainsymman.2011.07.004

• Palliative care
• critical care
• end of life
• quality improvement
• interprofessional

Background. Only a minority of patients who die in the medical intensive care unit (MICU) receive palliative care services. At the South Texas Veterans Health Care System Audie L. Murphy Hospital, only 5% of patients who died in the MICU from May to August 2010 received a palliative care consultation.
Measures. We measured the percentage of MICU patients for which there was a palliative care consultation during the intervention period.
Intervention. Starting October 1, 2010 and ending April 30, 2011, the palliative care and MICU teams participated in daily "pre-rounds'' to identify patients at risk for poor outcomes, who may benefit from a palliative care consultation.
Outcomes. Palliative care consultation increased significantly from 5% to 59% for patients who died in the MICU during the intervention period. Additionally, palliative care consultation increased from 5% to 21% for all patients admitted to the MICU during the intervention period.
Conclusions/Lessons Learned. Daily pre-rounds between the palliative care and MICU teams increased palliative care services for MICU patients at risk for poor outcomes, who may benefit from a palliative care consultation. J Pain Symptom Manage 2011;42:676-679. Published by Elsevier Inc. on behalf of U.S. Cancer Pain Relief Committee.

• 出版日期2011-11