Title

Integrating Palliative Medicine and Critical Care in a Community Hospital.

Publication/Presentation Date

11-1-2006

Abstract

Our objective was to describe the rationale and implementation of educational, environmental, clinical, and communication interventions designed to maximize indicators of improved palliative care in a community hospital intensive care unit. Surveys were used to develop educational content and methods for all levels of clinical staff and medical education. All clinical staff expressed confidence in clinical palliative processes but not in communication and psycho-spiritual issues shared with patient/families. An ambassador program and expanded visiting hours turned the waiting room into part of the therapeutic environment. New palliative order sets and practice guidelines were introduced. Interdisciplinary care planning was guided by a family communication record. Communication with families was enhanced by the use of the ambassadors, comprehensive care planning and sharing with the family within 24-48 hrs of admission, and ongoing meetings triggered by care plan changes. Quality indicators for intensive care unit-based palliative care proposed by experts provided a benchmark for evaluating the completeness of our intervention. Although not easily measured or demonstrated, it is our implicit assertion that this set of process and education interventions changed the daily nature of discourse in the intensive care unit among staff and between the staff, patients, and families.

Volume

34

Issue

11 Suppl

First Page

394

Last Page

398

ISSN

0090-3493

Disciplines

Critical Care | Critical Care Nursing | Medical Sciences | Medicine and Health Sciences | Nursing | Other Nursing | Palliative Care

PubMedID

17057604

Peer Reviewed for front end display

Peer-Reviewed

Department(s)

Department of Medicine, Department of Medicine Faculty, Section of Palliative Medicine and Hospice

Document Type

Article