• Traci N Phillips, Denise K Gormley, and Sherry Donaworth.
• Traci N. Phillips is a board-certified adult acute care nurse practitioner and a member of the pulmonary and critical care service at Bon Secours Mercy Health Anderson, Cincinnati, Ohio.
• Crit Care Nurse. 2024 Apr 1; 44 (2): 414841-48.

BackgroundPatients admitted to the intensive care unit have complex medical problems and increased rates of mortality and recurrent hospitalization for the following 10 years compared with patients without a history of critical illness. Delayed access to palliative care can result in untreated symptoms, lack of understanding of care preferences, and preventable admissions. Despite studies supporting palliative care screening, there is no standardized method to assess palliative care needs of patients admitted to critical care units.Local ProblemA community hospital critical care team identified a need for an improved palliative care process for patients admitted to the intensive care unit.MethodsThe aim of this quality improvement project was to improve patient access to timely palliative care consultation while increasing the reach of the palliative care team. Guided by the Institute for Healthcare Improvement model of plan-do-study-act cycles, the team created a palliative care screening tool with clinical indicators for nurses to use upon patient admission. Patients with numeric scores indicating positive screening tool results could be automatically referred for palliative care consultation.ResultsOf 267 patients, 59 (22%) had positive screening tool results, compared with 31 (11.6%) identified with the traditional consultative method. Descriptive analysis revealed that patients identified for referral without use of the screening tool were hospitalized a mean of 6 days until consultation was requested.ConclusionThe screening process can maximize the benefit of palliative care services with early patient identification, improved consultation efficiency, decreased critical care resource use, and reduced readmission rates.©2024 American Association of Critical-Care Nurses.

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