Developing triggers for the surgical intensive care unit for palliative care integration.
PURPOSE: Despite the growing acceptance of palliative care as a component of high-quality care for patients with serious illness, it remains underutilized in the surgical critical care setting. This article provides insight into a model for palliative care integration into the surgical intensive care unit (SICU), using triggers.
METHODS: We performed a prospective cohort study after the implementation of a new set of palliative care triggers in the SICU of an 1170-bed tertiary medical center over the course of 9 months. We aimed to determine the ability of these triggers to identify patients who would benefit from palliative care consultation.
RESULTS: There were 517 SICU admissions during the period of interest. Of this cohort, patients who had not yet been discharged at the time of analysis were excluded (n=25), and the remaining underwent analysis (n=492). Factors significantly associated with hospital death or hospice discharge were repeat SICU admission, metastatic/advanced cancer, SICU physician referral, and the matching of 2 or more secondary criteria.
CONCLUSIONS: A series of triggers can help identify patients who may benefit from palliative care consultation. This approach can be used in intensive care settings to facilitate palliative care integration.
Published In/Presented At
Finkelstein, M., Goldstein, N. E., Horton, J. R., Eshak, D., Lee, E. J., & Kohli-Seth, R. (2016). Developing triggers for the surgical intensive care unit for palliative care integration. Journal of critical care, 35, 7–11. https://doi.org/10.1016/j.jcrc.2016.04.010
Medicine and Health Sciences
Department of Medicine