Integration of palliative care in the context of rapid response: A report from the improving palliative care in the ICU advisory board

Judith E. Nelson, Kusum S. Mathews, David E. Weissman, Karen J. Brasel, Margaret Campbell, J. Randall Curtis, Jennifer A. Frontera, Michelle Gabriel, Ross M. Hays, Anne C. Mosenthal, Colleen Mulkerin, Kathleen A. Puntillo, Daniel E. Ray, Stefanie P. Weiss, Rick Bassett, Renee D. Boss, Dana R. Lustbader

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Rapid response teams (RRTs) can effectively foster discussions about appropriate goals of care and address other emergent palliative care needs of patients and families facing life threatening illness on hospital wards. In this article, The Improving Palliative Care in the ICU (IPAL-ICU) Project brings together interdisciplinary expertise and existing data to address the following: special challenges for providing palliative care in the rapid response setting, knowledge and skills needed by RRTs for delivery of high-quality palliative care, and strategies for improving the integration of palliative care with rapid response critical care. We discuss key components of communication with patients, families, and primary clinicians to develop a goal-directed treatment approach during a rapid response event. We also highlight the need for RRT expertise to initiate symptom relief. Strategies including specific clinician training and system initiatives are then recommended for RRT care improvement. We conclude by suggesting that as evaluation of their impact on other outcomes continues, performance by RRTs in meeting palliative care needs of patients and families should also be measured and improved.

Original languageEnglish (US)
Pages (from-to)560-569
Number of pages10
JournalCHEST
Volume147
Issue number2
DOIs
StatePublished - Feb 1 2015

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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