Integration of Palliative Care Advanced Practice Nurses Into Intensive Care Unit Teams. (May 2017)

• Record Type: Journal Article
• Authors: O'Mahony, Sean; Johnson, Tricia J.; Amer, Shawn; McHugh, Marlene E.; McHenry, Janet; Fosler, Laura; Kvetan, Vladimir
• Is Part Of: American journal of hospice & palliative care. Volume 34:Number 4(2017)
• Page Start: 330
• Page End: 334
• Publication Date: 2017-05
• Subjects: team-based care -- health care costs -- palliative care -- advanced practice provider -- palliative care consultation -- economics; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909115627425
• Languages: English
• ISSNs: 1049-9091

Abstract

Background: Referrals to palliative care for patients at the end of life in the intensive care unit (ICU) often happen late in the ICU stay, if at all. The integration of a palliative medicine advanced practice nurse (APN) is one potential strategy for proactively identifying patients who could benefit from this service. Objective: To evaluate the association between the integration of palliative medicine APNs into the routine operations of ICUs and hospital costs at 2 different institutions, Montefiore Medical Center (MMC) and Rush University Medical Center. Methods: The association between collaborative palliative care consultation service programs and hospital costs per patient was evaluated for the 2 institutions. Hospital costs were compared for patients with and without a referral to palliative care using Mann-Whitney U tests. Results: Hospital nonroom and board costs at the Weiler campus of MMC were significantly lower for patients with palliative care compared with those who did not receive palliative care (Median = US$6643 vs US$12 399, P < .001). Cost differences for ICU patients with and without palliative care at Rush University Medical Center were not significantly different. Conclusion: Our evaluation suggests that the integration of APNs into a palliative care team for case finding may be a promising strategy, but more work is needed to determine whether reductions in cost are significant.