Evaluation of screening criteria for palliative care consultation in the MICU: A multihospital analysis

Background There are currently no comprehensive studies in critical care settings that have set out to examine the association of palliative care screening criteria with multiple, adverse patient outcomes. Methods A 7-item palliative care screen was developed from consensus reports. Medical intensive care unit (MICU) nurses at four hospitals screened patients upon admission during a 16-week period. Outcomes included percentage of patients screened and their percentage with consultations ordered. Patient screen scores were compared with mortality, hospice discharge and length of stay (LOS). Results During the period, 1071 patients were admitted to MICUs, of which, 59.3% were screened; 35.3% of patients screened positive. Patients with positive screens (n=225) were more likely to have a consult ordered (33.6% vs 3.4%; p Conclusions Decisions on the appropriateness for palliative care consultation in the MICU can be aided using a trigger screen. We recommend the use of this screen be considered in the MICU with the suggested revisions. Additional studies are needed to determine if the use of the trigger screen is associated with improved clinical outcomes.