[Journal article] Integrating Palliative Care Into a Neurosurgical Intensive Care Unit (NS-ICU): A Quality Improvement (QI) Project
28 Oct 2021
Authors: Choo Hwee Poi, Mervyn Yong Hwang Koh, Tessa Li-Yen Koh, Yu-Lin Wong, Wendy Yu Mei Ong, Chunguang Gu, Fionna Chunru Yow, Hui Ling Tan
Published in: Am J Hosp Palliat Care. 2021 Sep 15:10499091211045616. doi: 10.1177/10499091211045616. Epub ahead of print. PMID: 34525873.
Summary points:
- The ICU-Palliative Care collaborative comprising of the palliative and intensive care team led the QI project with interventions included engaging key stake-holders, establishing formal screening and referral criteria, standardizing workflows and having combined meetings with interdisciplinary teams in ICU to discuss patients’ care plans
- The collaboration was beneficial in facilitating transfers out of ICU with more deaths outside ICU on comfort-directed care than patients not referred.
- Significantly more referred patients had a Do-Not-Resuscitation (DNR) order upon transfer out of ICU, had fewer investigations in the last 48 hours of life and reduced per-day ICU cost.