Merging Palliative and Critical Care Cultures in the Medical

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
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

Staff

Principal Investigators

• J. Andrew Billings, MD, Former 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

• Joel Bauman, MD
• Alexandra Cist, MD
• Edward Coakley, RN
• Constance Dahlin, MSN, ANP
• Paul Montgomery, PhD
• Taylor Thompson, MD
• Marilyn Wise, MSW, LICSW

Sponsor

• Robert Wood Johnson Foundation, "PROMOTING PALLIATIVE CARE EXCELLENCE IN INTENSIVE CARE"

Documents Developed During the Study

• Structured Family Meeting
• Family Meetings Bibliography
• Guide to Family Meetings (3 x 5 format)
• Palliative Care Nurse Champions
• Medical ICU Family Brochure
• Multidisciplinary Rounds
• House Officer daily Worksheet
• Vent Withdrawal Protocol
• "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.
• "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.
• "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.