Critical Care and Palliative Care Medicine Together in the ICU

Does Early vs Usual Palliative Care Consultation Augment the Critical Care Physician to Decrease Healthcare Utilization and Increase Caregiver Satisfaction

Will earlier palliative care medicine consultation in the ICU result in decreased length of stay in the ICU and hospital, as well as, increased patient and family satisfaction. Secondary questions to be answered is if this early consultation changes ICU and hospital death, discharge destinations, hospice admissions, code status changes, and withdrawal of life sustaining interventions.

1. Age >80 years
2. Apache II score >14
3. SOFA score > 9
4. Pre-existing functional dependency (admitted from ALF, SNF, LTAC, etc.)
5. Late stage dementia (bed-bound, nonverbal, incontinent, or unable to self-nourish/tube feed)
6. Stage 4 metastatic disease
7. Consideration to place permanent feeding tube or trach
8. Recurrent ICU admissions in the past year
9. Post-cardiac arrest
10. End-stage disease (lung, ESRD, ESLD)
11. ICU perceived need