Center to Advance Palliative Care

For Patients and Families
Partner
Sponsor
 
  Print this page
Views

CAPC Palliative Care Discussion Forum
Palliative Care and the ICU

Next Reply: Re:Mandated family meetings?
Previous Message: DNRs in ICU
Next Message: waiting rooms

Post Mandated family meetings?
Author: sgrommel
Date: Jun 18, 2008 2:27 pm
We provide palliative care consultation in a 700 bed private hospital. We have approximately 120 ICU beds and an open ICU model. In a hospital like ours, where physicians are paid for seeing patients, how would you incentivise or enforce physicians to conduct mandatory family meetings?
Replies: order by [Date] [Author] [Subject]
+ Re:Mandated family meetings? (by SharolHerr on 06/18/2008)
A large component of acute palliative care services' success has been their willingness, skill and availability to conduct family meetings. The skill level of the palliative professionals can facilitate decision making and establishment of goals of care. For employed physicians in the ICU the imperative could be for recognizing indicators for making palliative consults. This can off-load some of the intense family interactions and make them available to see more patients and focus on the ICU issues. A possibility is to establish quality and financial outcomes that could be measured to evaluate the employed physician. There are a wealth of elements that could be evaluated such as documentation of advanced directives, establishing DNR, goals of care discussions, interdisciplinary collaboration, outcomes post intubation, LOS in ICU, etc. Triggers for consult could include: LOS in ICU, presence of multi-organ system failure, # of consultants, request for trach or PEG placement, etc. The key is to link practice with measurable outcomes. Sharol Herr, RN, MSEd, CHPN; Palliative Nurse Clinician/Education Coordinator; Mt. Carmel Health Palliative Care Leadership Center; Columbus, Ohio.

IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must login. If you are not a registered member you may join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.


General questions about using the CAPCconnect™ palliative care discussion forum? EmailPatricia.Caines@mssm.edu

Lost login username/password questions? Email: Margaret.Schutz@mssm.edu