Description

Shore Memorial Hospital instituted a program of family meetings facilitated by a Palliative Care RN for all ICU patients. A review of six months of family meetings has demonstrated an avenue for adoption of the Palliative Care philosophy in the ICU. One of the challenges to previous multidisciplinary family meetings was unavailability of physicians during daytime hours. The RN facilitator was able to gain physician “buy-in” to initiate discussions with the patient and family prior to any Palliative Care consult. Topics discussed regarded the presence of an advanced directive, how the intent of an advanced directive should be reflected in the individual’s code status, as well as pain management, dyspnea management, prognosis and goals. The facilitator leads the multidisciplinary meeting and reports back to the attending physician the findings of the meeting, making recommendations for Palliative Care consults when appropriate. The family meeting program was able to demonstrate an overall increase in Palliative Care consults hospital wide by 69%, decrease the number of days between admission to the ICU and a Palliative Care consult, and often reflect a decrease in the daily charges on patients who received a Palliative Care consult.