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CAPCconnect™ palliative care discussion forum

Palliative Care and the ICU

Number of threads on this Forum: 65
Subject Author Posts Last Post
Post Critical Care Codes Veronica 4 11/04/2014
Hi-I am new to billing for Palliative Care. I am noticing my doctor never uses Critical Care CPT codes 99291 & 99292. After reading other post, it seems that my Palliative Care doctor can bill Critical Care CPT codes but she is not educated on this. Can y ...
Post Policy for deactivating AICD? LoriOlalla 2 10/03/2014
We need a policy for the patient's end-of-life choice to deactivate her/his AICD, whether in the hospital or in the home while on hospice. Does anyone out there already have a policy which they could share? Our healthcare system's current policy only addr ...
Post Withdrawal of Vent / Mortality Stat Concern ceaelle 3 09/15/2014
Since the inception of our Palliative Care program it has been our practice at our hospital that this team support a patient and family up to, during and after the decision for ventilator withdrawals. Should the patient survive extubation for a while and ...
Post Proposed integrated project for COPD and stroke janabraklow2010 2 09/11/2014
I am a DNP student at the University of Nebraska Medical Center. I am an acute care nurse practitioner in Critical Care and I also specialize in Palliative Care. I lead our palliative care team at a community hospital in Kansas City. As part of an assignm ...
Post Palliative Care NICU physicians KimDeRosa 2 01/20/2014
Hi all- Looking for some salary information for a NICU Palliative Care physician. Any info would be helpful, or maybe someone could point me in the direction of where to find some info on this. Thanks in advance Kim
Post benchmark for % of ICU admits with referral to PC AndrewLand 2 11/13/2013
Our hospital is approx 150 bed community hospital, with a 12 bed ICU. I am tracking total ICU admits and the # of referrals to in-pt. PC from the ICU. We are averaging about 10-15% of all ICU admits getting referred to our in-pt. PC services, and I am l ...
Post Try Something at Death - The Gray DNR Order Lustbader 1 10/18/2013
Occasionally families request that "something" be tried at death for a terminally ill patient when death is certain. This may come from strong religious values (i.e. Orthodox Jews) or something else. They may say, we don’t want mom intubated or shock ...
Post language for nursing staff EMun 2 07/30/2013
We have an established Palliative Care Team at Kaiser Hawaii. As an APRN and nursing staff member, I am looking to implement a screening protocol in our ICU that will initiate a consult to the Palliative Care Team on a regular basis. Some of our nursing s ...
Post critical care billing careS 2 07/03/2013
Hi If we see a patient for initial consult in icu who fulfills the criteria to bill a 99291 should we bill a 99255 or can we do a 99291? For example we saw an initial consult and did the terminal wean the same day, what would be the best way to bill? ...
Post Propofol policies - extubation to comfort care drosielle 3 05/16/2013
I am being asked to speak at my institution's adult critical care committee about allowing propofol to be used for symptom control in patients who are being extubated to comfort care with the expectation they will die quickly. Currently, the institution f ...
Post PALLIATIVE CARE BILLING mmoroney 1 04/11/2013
Let me start by explaining, I am new to palliative care billing. Normally when billing a evaluation and management code, the chief compliant assists in establishing the medical necessity of a visit. With PC, when a provider sees a patient for comfort ca ...
Post Locked-in Syndrome WRNFNP 1 01/04/2013
Does anyone know of any good articles discussing Palliative Care and Locked-in Syndrome?
Post Exam Review Audio Cd polive 1 11/30/2012
Does anyone know of review cd's for the Hospice and Palliative Care Certification Exam (RN-nursing level) Thanks in advance, Phyllis Olive, RN
Post Readmissions and Mortality ChristieHerrick 2 12/07/2012
Hi - we have had some of our hospital partners state that if a patient is receiving palliative services in the hospital a death will not count against their mortality. And a new assumption that a few physicians have raised is that if the patient is in o ...
Post Readmissions and Mortality ChristieHerrick 2 11/30/2012
Hi - we have had some of our hospital partners state that if a patient is receiving palliative services in the hospital a death will not count against their mortality. And a new assumption that a few physicians have raised is that if the patient is in o ...
Post Readmissions and Mortality ChristieHerrick 4 12/03/2012
Hi - we have had some of our hospital partners state that if a patient is receiving palliative services in the hospital a death will not count against their mortality. And a new assumption that a few physicians have raised is that if the patient is in o ...
Post Palliative care in the ICU Ukhan 2 10/30/2012
Our hospital has partnered with a major health insurance carrier on a palliative care initiative in the ICU. There is fair amount of resistance and the number of consults are low from the ICU. A form for the family meeting and goals of care conversation h ...
Post IPAL/Critical Care Kathi 4 10/11/2012
Can those hospitals who are running the IPAL program model in their hospitals identify themselves? It would be helpful to have a conversation with someone who is actively implementing this program with regard to successes and difficulties. Thank you.
Post No Escalation of Care hstuch 3 06/22/2012
Does anyone have a policy on "no escalation of care" in the ICU. We want to be able to clarify and standardize which inetrventions should not be offered or initiated in a patient with a poor prognois in the unit.
Post PC triggers for eICU cblais 3 05/30/2012
We have begun using an eICU to remotely monitor ICU patients, after hours, at several of our system hospitals. Other than the triggers already noted in the Portfolio and the article by Nelson, et al in CCM, does anyone have any experience with triggers in ...
Post ICU leaflet DeannaBrame 2 05/02/2012
We are moving forward with ICU PC project and following care and communication quality measures, which includes giving patient/family ICU information leaflet. Does anyone have one to share? I see one posted in capc resources from Mount Carmel, any others ...
Post nurse driven PC protocols? mcornell 2 03/26/2012
Have any of you implemented any nurse driven protocols in support of your palliative care program, e.g. nurse-driven protocol to order palliative consult; drive driven order to initiative PC standing orders, etc....?
Post what is IPAL -ICU lambert 2 02/07/2012
hi i am doing my BSc hons and my project is about the intergration of palliative care into ICU i have been reading about IPAL-ICU and wondered if anyone can tell me how this came about and why
Post Partial DNR's Deb 2 01/25/2012
Hi, My group of intensivists are finally getting fed up with partial DNR orders, like chemical code only. There are only a few physicians still writing this and these are usually the physicians who resist allowing palliative care involvement too, so I hav ...
Post ICU LOS akrause 6 10/31/2012
Two questions: Does anyone have data on how much a proactive palliative care consult impacts a PC service LOS? Hospital administrators are looking at the total LOS but if PC gets involved on HD #2, after a positive palliative care screen, our LOS increas ...
Post subcutaneous catheter policies ultrapollo08 1 08/29/2011
We are beginning to provide more acute palliative care to our patients and would like to adopt a subcutaneous catheter infusion policy. I have a sample for our local hospice but was wondering if someonw could share this policy with me. I am challenged to ...
Post ICU/PC Representation on Ethics Committees HilliardB 7 12/02/2011
Looking for information on ICU or palliative care representation on the institution's ethics committee. If your hospital has an "active and effective" committee, does anyone from ICU or the palliative care service serve as a member?
Post Written Consent to withhold withdraw life support ultrapollo08 2 08/24/2011
In Nevada we have a law that requires written consent to withhold or withdraw life support. Can someone share with me the laws governing this in the state they practice in? I am working with legislation to change this to implied consent NRS 449.626 ...
Post Palliative Care in CCU HilliardB 2 08/08/2011
One way to increase requests for PC consults is to ask for help from the hospital's ethics committee. Ethics committees have a variety of strategies and ideas for instituting "culture change" and helping physicians and families see the value of PC.
Post pt in denial and upset about talking about illness maryg 3 08/04/2011
elderly female with lung cancer and in ICU with sob referal to discuss goals of care. When I spoke with patient she stated she could never discuss if she would want to stop aggressive therapy. I agreed I would not bring up again since was upsetting. Went ...
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