Merging cultures: palliative care specialists in the medical intensive care unit.

@article{Billings2006MergingCP,
  title={Merging cultures: palliative care specialists in the medical intensive care unit.},
  author={Joanna Billings and Adele Keeley and Joe Bauman and Alexandra F.M. Cist and Edward E. Coakley and Constance Dahlin and Paul Montgomery and Boyd Taylor Thompson and M Wise},
  journal={Critical care medicine},
  year={2006},
  volume={34 11 Suppl},
  pages={
          S388-93
        }
}
We summarize the key interventions and general findings from a 3-yr project titled, "Merging Palliative and Critical Care Cultures in the Medical Intensive Care Unit." This multifaceted demonstration project was designed so palliative care and intensive care clinicians would share their expertise and develop projects that promote end-of-life care in a medical intensive care unit (ICU) setting. A variety of interventions are described, including collaborating with ICU leaders, training nurses as… 
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Improving palliative care in intensive care units: identifying strategies and interventions that work.
  • I. Byock
  • Medicine
    Critical care medicine
  • 2006
TLDR
This article introduces this special supplement of Critical Care Medicine, which describes the developments that have occurred moving us toward integration of palliative and critical care, and lays the foundation for the articles published in this supplement.
Integrating Palliative Care Into the ICU: From Core Competency to Consultative Expertise
TLDR
A model describing levels of integration of palliative care into the care of ICU patients and some patients will benefit from the full range of expertise provided by a separate consulting team, with additional training, focused on caring for patients with palliatives care needs across the full spectrum of patient locations within a health system is proposed.
Palliative care in the intensive care unit: an interview-based study of the team perspective
TLDR
This qualitative interview-based study aimed to explore the Stirling Royal Infirmary ICU team’s views and experiences of the difficulties of providing palliative care in an intensive care setting, and identification of the dying patient.
Integrating palliative and critical care: evaluation of a quality-improvement intervention.
TLDR
A single-hospital, before-after study of a quality-improvement intervention to improve palliative care in the ICU found but significant improvement in nurse-assessed quality of dying and reduction in ICU length of stay with an intervention to integrate palliatives care inThe ICU.
Integrating palliative care in the intensive care unit.
Models for structuring a clinical initiative to enhance palliative care in the intensive care unit: A report from the IPAL-ICU Project (Improving Palliative Care in the ICU)*
TLDR
There are two main models for intensive care unit-palliative care integration: 1) the “consultative model,” which focuses on increasing the involvement and effectiveness of palliative Care consultants in the care ofintensive care unit patients and their families, particularly those patients identified as at highest risk for poor outcomes.
In their own words: Patients and families define high-quality palliative care in the intensive care unit*
TLDR
From 48 subjects in nine focus groups across three sites, a shared definition of high-quality intensive care unit palliative care emerged: timely, clear, and compassionate communication by clinicians; clinical decision-making focused on patients' preferences, goals, and values.
Speaking a Different Language: A Qualitative Analysis Comparing Language of Palliative Care and Pediatric Intensive Care Unit Physicians
TLDR
Pediatric ICU physicians spend more time giving medical information, whereas the palliative care team more commonly offers emotional support, and the addition of the PC team to ICU family conferences may provide a balanced approach to communication.
The Clinical Nurse Specialist Role in Developing a Geropalliative Model of Care
TLDR
The structure, processes, and outcomes of care can be positively impacted by the CNS during the development and implementation of a palliative model of care through activities such as direct consultation, educational initiatives, mentoring, and disseminating assessment and care planning tools.
Effectiveness of integration of palliative medicine specialist services into the intensive care unit of a community teaching hospital.
TLDR
Integrating palliative medicine specialists into intensive care was associated with a significant increase in use of palliatives medicine services and a significant decrease in ICU length of stay for referred patients without a significant rise in mortality.
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