Introduction: Despite evidence supporting early palliative care (PC) in the ICU, referrals remain inconsistent, often delayed, and dependent on individual provider discretion. This variability contributes to missed opportunities for goal-concordant care, increased moral distress, and potential legal risks. Our institution identified a gap in standardized PC referral processes and sought to implement a structured, evidence-based approach to improve timely and appropriate PC integration. Methods: A multidisciplinary team developed a three-pronged intervention targeting ICU teams, patients/families, and the PC service. Key components included: (1) a validated scoring tool based on referral criteria (e.g., prolonged ICU stay, symptom burden, unclear goals of care); (2) educational materials for patients and clinicians; and (3) standardized documentation and rounding workflows. Baseline data were collected on ICU admissions, referral patterns, and staffing needs. ICU physicians, advanced practice providers and nurse were trained. Post-implementation data and feedback were collected and discussed with multidisciplinary ICU team leading to process refinement. Note: AI assisted with formatting of the abstract submission but did not contribute to content of the project. Results: Preliminary findings indicate improved identification of patients with unmet PC needs, increased confidence among ICU staff in initiating referrals, decreased moral distress and enhanced interdisciplinary communication. The scoring tool was used consistently during rounds, and early feedback suggests improved alignment of care with patient goals. Full data analysis is ongoing at time of abstract submission and will include quantitative and qualitative data as well as feedback from ICU and PC teams. Conclusions: Embedding a standardized PC referral process into ICU workflow is feasible, well-received, and shows early promise in improving care delivery resulting in better outcomes and higher engagement of the multidisciplinary team. This model supports scalable, sustainable integration of PC into critical care settings, ensuring patients receive the right care at the right time.
Janine Galeski (Sun,) studied this question.