A model for increasing palliative care in the intensive care unit: Enhancing interprofessional consultation rates and communication

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.