SHM Converge Scientific Abstract ePoster Gallery-Icups: Review of Trigger Critera for Palliative Care Consults

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This study evaluated whether implementing palliative care (PC) trigger criteria in the ICU increased consultation rates. The trigger criteria were based on prior evidence and included NYHA Class 4, stage 4 malignancy, multiple organ failure involving more than three systems, ICU stay longer than 7 days, and advanced dementia. The team also created a new PC consult order set and placed a PC team member in daily ICU multidisciplinary rounds to improve collaboration.<br /><br />Researchers compared ICU admissions from February 1 to August 1, 2023, before trigger criteria were used, with the same months in 2024 after implementation. The pre-trigger group included 177 ICU patients, and the post-trigger group included 239 patients. The average patient age was 68 years, and 56% were male. Overall mortality was about 32%.<br /><br />Before trigger implementation, 28.8% of patients had a PC consult; after implementation, 26.8% had a consult. This difference was not statistically significant. Average ICU length of stay decreased from 4.2 days to 3.39 days after trigger initiation, but this change was also not statistically significant.<br /><br />The most common reasons prompting PC consultation were multiorgan failure and ICU admission lasting more than 7 days.<br /><br />In conclusion, introducing trigger criteria did not significantly increase palliative care consults during the 6-month evaluation period. Despite a 25% increase in ICU census, the proportion of PC consults remained essentially unchanged. The authors plan to continue the evaluation over a full year to determine whether longer-term trends emerge.

Asset Subtitle

Yalda Chalabi

Meta Tag

Author List Amanda Frugoli, Andrew Bas, Colin Scibetta, David Do, Hana Chakalian, Lucas Chandra, Yalda Chalabi

Category Research

Concept Palliative Care Consultation

Concept Trigger Criteria

Concept ICU

Concept Palliative Care Consult Utilization

Concept Advanced Heart Failure

Distinguished Non-Finalist

Presenter Organization Community Memorial Health System

Presenting Author Yalda Chalabi

Track Quality Improvement

Keywords

palliative care

ICU

trigger criteria

consultation rates

multiorgan failure

advanced dementia

NYHA Class 4

ICU length of stay

multidisciplinary rounds

mortality

Palliative Care Consultation

Trigger Criteria

ICU

Palliative Care Consult Utilization

Advanced Heart Failure