May Hua1, Hannah Wunsch. 1. aDepartment of Anesthesiology, Columbia University, New York, New York, USA bDepartment of Critical Care Medicine, Sunnybrook Hospital cDepartment of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: Although providing palliative care in the ICU has become a priority, the success of different methods to integrate palliative care into the ICU has varied. This review examines the current evidence supporting the different models of palliative care delivery and highlights areas for future study. RECENT FINDINGS: The need for palliative care for ICU patients is substantial. A large percentage of patients meet criteria for palliative care consultation and there is frequent use of intensive care and other nonbeneficial care at the end of life. Overall, the consultative model of palliative care appears to have more of an impact on patient care. However, given the current workforce shortage of palliative care providers, a sustainable model of delivering palliative care requires both an effective integrative model, in which palliative care is delivered by ICU clinicians, and appropriate use of the consultative model, in which palliative care consultation is reserved for patients at highest risk of having unmet or long-term palliative care needs. SUMMARY: Developing a mixed model of palliative care delivery is necessary to meet the palliative care needs of critically ill patients. Efforts focused on improving integrative models and appropriately targeting the use of palliative care consultants are needed.
PURPOSE OF REVIEW: Although providing palliative care in the ICU has become a priority, the success of different methods to integrate palliative care into the ICU has varied. This review examines the current evidence supporting the different models of palliative care delivery and highlights areas for future study. RECENT FINDINGS: The need for palliative care for ICU patients is substantial. A large percentage of patients meet criteria for palliative care consultation and there is frequent use of intensive care and other nonbeneficial care at the end of life. Overall, the consultative model of palliative care appears to have more of an impact on patient care. However, given the current workforce shortage of palliative care providers, a sustainable model of delivering palliative care requires both an effective integrative model, in which palliative care is delivered by ICU clinicians, and appropriate use of the consultative model, in which palliative care consultation is reserved for patients at highest risk of having unmet or long-term palliative care needs. SUMMARY: Developing a mixed model of palliative care delivery is necessary to meet the palliative care needs of critically illpatients. Efforts focused on improving integrative models and appropriately targeting the use of palliative care consultants are needed.
Authors: Sarina R Isenberg; Christopher Meaney; Peter May; Peter Tanuseputro; Kieran Quinn; Danial Qureshi; Stephanie Saunders; Colleen Webber; Hsien Seow; James Downar; Thomas J Smith; Amna Husain; Peter G Lawlor; Rob Fowler; Julie Lachance; Kimberlyn McGrail; Amy T Hsu Journal: BMC Health Serv Res Date: 2021-04-13 Impact factor: 2.655