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Hospital and Hospice Partnerships

Next Reply: Re:Hospice in the ICU
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Post Hospice in the ICU
Author: LibbyT
Date: Mar 3, 2010 10:56 am
Hi - I am new to this forum. We have a well-established palliative care service in a large metropolitian hospital in Houston. We are very active in our ICUs and have a proactive palliative care pilot program to reduce death in the ICU underway. We have in-hospital hospice beds available and contract with a local hospice for the care and overall we are quite successful at hospice transition to appropriate settings. Now our administration wants us to set up a program to hospice patients in the ICU setting (i.e. just 'flip the bed' to hospice). Our PC team is opposed to this as is our hospice vendor. I'm interested in perspectives and if anyone is currently doing this.
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+ Re:Hospice in the ICU (by angieshelton on 03/03/2010)
I do not think ICU is the appropriate place for a hospice pt. The nurses that work ICU are in the "curative" mode. Someone that is actively needs a "special" touch.
Re:Hospice in the ICU (by angieshelton on 03/03/2010)
I'm sorry I ment to say actively dying, needs a special touch.
Re:Hospice in the ICU (by Deb on 03/03/2010)
I too do palliative care and the ICU's keep me quite busy. The goal is to reduce LOS in the ICU. If we withdraw on a pt who does not look like they will die in the elevator, we transfer to our oncology/palliative care unit for EOL/comfort care. So we are going to lower level of care, and if the pt is not actively dying, I refer to hospice who may then "flip" them to GIP, but GIP is on our unit which is considered acute care and not taking up ICU bed. If the pt still seems pretty stable the hospice will then discuss with family, going to the hospice house, if pt meets criteria, custodial level of care at SNF, or home. While sometimes the family and nurses in the ICU prefer to stay there because they have become attached, it does not make sense to take up an ICU bed and ICU nurse, and I always write orders to transfer if stable enough. Sometimes I find, the ICU will keep them until the bed is needed, but it usually works well.

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