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Objective:

The purpose of this study was to examine the effect of proactive palliative care consultation on length of stay for high-risk patients in the medical intensive care unit (MICU).

Design:

A prospective pre/post nonequivalent control group design was used for this performance improvement study.

Setting:

Seventeen-bed adult MICU.

Patients:

Of admissions to the MICU, 191 patients were identified as having a serious illness and at high risk of dying: 65 patients in the usual care phase and 126 patients in the proactive palliative care phase. To be included in the sample, a patient had to meet one of the following criteria: a) intensive care admission following a current hospital stay of≥ 10 days; b) age> 80 yrs in the presence of two or more life-threatening comorbidities (eg, end-stage renal disease, severe congestive heart failure); c) diagnosis of an active stage IV malignancy; d) status post cardiac arrest; or e …