Abstract
Care provided to seriously ill patients at the end of life is viewed as a significant indicator of health care quality. Many patients with serious illnesses are admitted to an intensive care unit, where the primary focus is on reversing or controlling illnesses. This can result in decreased patient satisfaction, unnecessary testing, and poor symptom management. This study monitored the patient satisfaction, length of stay, variable costs, and mortality and readmission rates of seriously ill patients at a small community hospital. The patients had been admitted to a medical-surgical intensive care unit (MSICU) where end-of-life palliative care consultative services were absent. The purposes of this quality improvement study were to (a) develop and implement a robust palliative care program for intensive care patients at a small community hospital and (b) evaluate whether the study approach was successful in improving care delivery at the end of life. The primary focus was for the compassionate care team to provide an added support to patients at the end of life. An evaluation of the data suggested the need for early palliative care consultations to improve program effectiveness.