Introduction of triggers for palliative care consultation improves utilization and satisfaction within a level four NICU

Introduction of triggers for palliative care consultation improves utilization and satisfaction within a level four NICU

Nguyen LT; Cooperberg DB; Spear ML

10.1038/s41372-018-0067-1

Journal of Perinatology

2018

Hospitals; Humans; Intensive Care Units; Neonatal/organization & administration/standards; Palliative Care/standards/statistics & numerical data; Patient Care Team/organization & administration; Pediatric; Personal Satisfaction; Referral and Consultation/statistics & numerical data

OBJECTIVE: We sought to explore the beliefs regarding palliative care team utilization, as well as increase consultation and awareness of the palliative care team's role in the NICU. STUDY DESIGN: The study design in this Level 4 NICU included observational time series with multiple planned sequential interventions. Medical chart review was conducted to determine eligibility, and statistical process control charts were used to show performance over time. RESULTS: Prior to implementation of the triggers, 26% received consultation, which increased to 46% after implementation. There was an increase in level of understanding, knowledge of team's role, and improved utilization. The time until initial consultation decreased from ~1.5 months to 1 week. CONCLUSIONS: We observed a 20% increase in consultations. Key interventions included continual education, reminders, and clear postage of the trigger list. Written guidelines increase awareness of a palliative care team's role within a NICU, and provider satisfaction.

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