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Hindi Research Article
Lessons Learned from a Palliative Care-Related Communication Intervention in an Adult Surgical Intensive Care Unit
Rebecca A. Aslakson1,*, Maureen Coyle2, Rhonda Wyskiel3, Christina Copley3, Kathryn Han3, Nita Ahuja4 and Peter J Pronovost11Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, USA
2Department of Surgical Social Work, The Johns Hopkins Hospital, Baltimore, USA
3Department of Surgical Nursing, The Johns Hopkins Hospital, Baltimore, USA
4Department of Surgery and Oncology, The Johns Hopkins University School of Medicine, Baltimore, USA
- *Corresponding Author:
- Rebecca A. Aslakson, MD, PhD
Department of Anesthesiology and Critical Care Medicine
The Johns Hopkins School of Medicine
Baltimore, USA
Tel: 410-955-9082
Fax: 410-955-8978
E-mail: raslaks1@jhmi.edu
Received date: December 30, 2014 Accepted date: November 28, 2015 Published date: November 30, 2015
Citation: Aslakson R, Coyle M, Wyskiel R, Copley C, Han K, et al. (2015) Lessons Learned from a Palliative Care-Related Communication Intervention in an Adult Surgical Intensive Care Unit. J Palliat Care Med 5:240. doi:10.4172/2165-7386.1000240
Copyright: © 2015 Aslakson RA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Purpose: Multi-disciplinary, palliative care-related family meetings for intensive care unit(ICU) patients can decrease ICU length-of-stay and family anxiety and distress, but it is unclear how to arrange such meetings in surgical ICUs (SICUs). Materials and Methods: Through meetings with SICU clinician stakeholders, we determined trigger criteria and intervention content. We piloted the intervention over 6 months in a single, 16-bed adult SICU. Results: Clinician stakeholders reached consensus for a 7 day trigger criteria. A social worker arranged the multi-disciplinary meetings. During the six month pilot, 25 patients were identified but only approximately 60% received meetings. The 7 day trigger identified a patient population with high in-hospital mortality (44%) and prolonged ICU and hospital median lengths of stay (34 and 43 days, respectively). The pilot was stopped at 6 months due to high burden of work for social workers and an inability to standardize meeting content. Conclusion: The 7 day criteria for SICU admission identified a subset of high mortality SICU patients likely to benefit from proactive palliative care-related meetings. Meetings were arranged but the format did not ensure meeting content and the intense time commitment of arranging meetings prevented sustainability.
