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Merging Palliative and Critical Care Cultures
in the Medical Intensive Care Unit

Principal Investigators:

J. Andrew Billings, MD, Director, MGH Palliative Care Service; Associate Professor of Medicine; Co-Director, Harvard Medical School Center for Palliative Care

Adele Keeley, BSN, MA, RN, Nurse Manager, MGH Medical Intensive Care Unit

Co-Investigators and Study Staff
Taylor Thompson, MD; Alexandra Cist, MD; Marilyn Wise, MSW; Paul Montgomery, Ph.D.

Sponsor:
Robert Wood Johnson Foundation, "PROMOTING PALLIATIVE CARE EXCELLENCE IN INTENSIVE CARE."

Specific Aims of the Project:
This is a quality improvement demonstration project whose aims are to: 1) improve and standardize physical and psychosocial/spiritual care approaches to the alleviation of suffering for all patients in the Medical Intensive Care Unit (MICU) and their families; 2) strengthen staff education and support programs to assure that every trainee and practitioner in the MICU is exposed to state-of-the-art palliative care; and 3) generate, publish, and otherwise disseminate useful evaluation data about transferable improvements, thus allowing us to serve as a model for other ICUs. The study design is a pre-post intervention Quality Demonstration Project.
Our hypothesis is that a set of clinical and educational interventions will promote the integration of patient-and-family-centered palliative care practice into the medical intensive care unit (MICU).

Presentation to the AAHPM in February, 2006.

Documents developed during the Study:

1. Structured Family Meeting

2. Family Meetings Bibliography

3. Guide to Family Meetings (3 x 5 format)

4. Palliative Care Nurse Champions

5. Medical ICU Family Brochure

6. Multidisciplinary Rounds

7. House Officer daily Worksheet

8. Vent Withdrawal Protocol

9. "Get to Know Me" Poster©, used in the MICU, developed by the MGH "Ethics in Clinical Practice" (EICP) committee, a part of the collaborative governance structure in the Patient Care Services department. Ordering information and Guidelines for use are also available..

10. "Preparing to be a Health Care Agent" brochure© (not printable). If you would like to purchase bulk copies of this brochure, please contact our print vendor Standard Register at 1-877-771-9063 and refer to item #84668.

11. "Planning in Advance for Your Health Care" brochure© (not printable). If you would like to purchase bulk copies of this brochure, please contact our print vendor Standard Register at 1-877-771-9063 and refer to item #84669.

For more information, please call 617-724-9197.

MGH Palliative Care Service, 55 Fruit Street, Founders 600, Boston, MA 02114
Telephone: (617) 724-9197 Fax: (617) 724-8693