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CAPC Palliative Care Discussion Forum
Palliative Care and the ICU
Triggers for MICUAuthor: ginat
Date: Aug 18, 2009 11:05 am
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There is an interesting discussion in the capc connect forum under "pallaitive care and the ICU/ mandatory consults" that includes discussion of triggers, how to invite buy-in from ICU staff, and research articles identifying outcomes of proactive palliative care consultation.
There is mixed experience with the use of triggers, likley reflecting the culture of the unit or hospital. Triggers are helpful if they help referring clinicians identify patients for palliative care and are not seen as overly burdensome or complicated. Use of triggers should be consistent with the overall marketing strategy and referral process.
Two simple, easy-to-remember descriptions of patients appropriate for palliative care(triggers) used in one of our community hospitals are:
1. unrelieved pain and other symptoms, 2. patient and family need for increased support, and 3. unclear goals of care.
Additional screening criteria for ICU patients:
LOS of 3-5 days or greater without plan for discharge from ICU, and multi-system organ failure.
Lyn Ceronsky
Director, Palliative Care
Fairview Health Service
A Palliative Care Leadership Center