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Next Reply: Re:RRT documentation as referral to palliative care
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Post RRT documentation as referral to palliative care
Author: pstark
Date: Oct 26, 2009 4:48 pm
Hello,
We are considering having a statement/suggestion for referral of a patient who has had a rapid response team call and for whom it has been determined that the patient would not benefit or desire further aggressive treatment.
Has anyone considered this option or seen it done? Our goal in suggesting this is to increase awareness that there is another alternative and to prompt conversation with the patient's family prior to transfer to the ICU.
Any feedback would be most welcome.
Thank you,
Phyllis Stark, Director Palliative Care
CRMC, Fresno, CA
Replies: order by [Date] [Author] [Subject]
Re:RRT documentation as referral to palliative care (by mrabow on 10/27/2009)
Hi,
I'm looking forward to seeing others' response to your query. Having routine/automatic indicators for initiating palliative care consults can serve a number of purposes. First, clearly, it can increase referrals to your service. Second, it can prompt the pc team to work closely to the referring service to identify needs and opportunities. Third, it can allow the pc to gain deep expertise in a particular area.
Best,
Michael W Rabow, MD, Associate Director, UCSF PCLC
Re:RRT documentation as referral to palliative care (by vrandazzo on 03/08/2011)
I agreed with Dr. Rabow. I am hoping to create a tool that will help our health care providers with this endeavors
Re:RRT documentation as referral to palliative care (by vrandazzo on 03/08/2011)
I agreed with Dr. Rabow. I am hoping to create a tool that will help our health care providers with this endeavors
Re:RRT documentation as referral to palliative care (by vrandazzo on 03/08/2011)
I agreed with Dr. Rabow. I am hoping to create a tool that will help our health care providers with this endeavors
RRT and Palliative Care (by Lustbader on 03/08/2011)
The concept of a rapid response team member initiating a "STAT" palliative care conversation while a patient is in extremis is fascinating. We frequently struggle with this with about 30% of our rapid response calls resulting in palliative care consultation. Reports range from 10-50%. This may explain why the institution of a rapid response process does NOT impact on hospital mortality since many of the patients for whom a rapid response is called, are dying from terminal disease and would die, with or without life sustaining interventions. When I am the ICU attending, my rapid response pager and palliative care pager go off simultaneously. We are now training our second year residents how to have a “STAT Goals of Care Discussion” during a rapid response. They do not have the skills and simply panic, code the patient and send them to the ICU because it is easier and they are less likely to “get in trouble” from the attending of record.

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