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Chest. 2015 Feb;147(2):560-569. doi: 10.1378/chest.14-0993.

Integration of palliative care in the context of rapid response: a report from the Improving Palliative Care in the ICU advisory board.

Author information

1
Icahn School of Medicine at Mount Sinai, New York, NY.
2
Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: kusum.mathews@mssm.edu.
3
Medical College of Wisconsin, Milwaukee, WI.
4
Wayne State University, Detroit, MI.
5
University of Washington School of Medicine, Seattle, WA.
6
The Cleveland Clinic, Cleveland, OH.
7
VA Palo Alto Health Care System, Menlo Park, CA.
8
Rutgers New Jersey Medical School, East Orange, NJ.
9
Hartford Hospital, Hartford, CT.
10
University of California, San Francisco, San Francisco, CA.
11
Lehigh Valley Health Network, Allentown, PA; Johns Hopkins University School of Medicine, Baltimore, MD.
12
Icahn School of Medicine at Mount Sinai, New York, NY; St. Luke's Hospital, Boise, ID.
13
Hofstra North Shore-Long Island Jewish School of Medicine, Hempstead, NY.

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.

PMID:
25644909
PMCID:
PMC4314822
DOI:
10.1378/chest.14-0993
[Indexed for MEDLINE]
Free PMC Article

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