SCCM Resource Library-Death and Dying in the ICU: Bringing Lessons From ICU Liberation to End-of-Life ICU Care

Video Transcription

Video Summary

The panel discussed various aspects of high-quality end-of-life care in the ICU. They reviewed observational data that suggested room for improvement in end-of-life care practices, such as variability in withholding and withdrawing life support across different ICUs. They also highlighted the perception of appropriateness of care among clinicians, which revealed instances of delivering inappropriate care. The panel discussed the impact of poor quality care on family caregivers, which can lead to psychological symptoms such as depression, anxiety, and PTSD. They also emphasized the importance of family ratings of care quality and the need for patient and family-centered outcomes. The panel explored different models for integrating palliative care into the ICU, including primary palliative care, incorporation of palliative care specialists, and a mixed model with training in palliative care for ICU clinicians and palliative care consultation. They presented several studies that demonstrated proof of concept that these models can improve quality of care. The panel stressed the importance of focusing on improving communication, providing goal-concordant care, being good stewards of ICU resources, and basing variability in care on patient and family values. They concluded that high-quality end-of-life care in the ICU is multifaceted and requires collaboration among healthcare professionals to ensure patient and family-centered care.

Asset Subtitle

Ethics End of Life, Patient and Family Support, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Describe the key domains that define high-quality end-of-life ICU care
Apply existing end-of-life ICU care quality measures to practice and compare to national and international trends
Identify at least two key strategies that will help improve end-of-life care for patients in the ICU

What Is High-Quality End-of-Life Care?
J. Randall Curtis

Variability of End-of-Life Care in U.S. ICUs: Insights From the ICU Liberation Collaborative
Jacqueline Kruser

Trends in End-of-Life Care Over Time: A European Perspective
Charles L. Sprung

Meta Tag

Content Type Presentation

Knowledge Area Ethics End of Life

Knowledge Area Patient and Family Support

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Tag Palliative Care

Tag Brain Death

Tag Communication

Year 2021

Keywords

high-quality end-of-life care

ICU

observational data

withholding and withdrawing life support

appropriateness of care

family caregivers

psychological symptoms

palliative care

communication

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