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Colleen’s First QI Project, Part Four: Our First Group Meeting

By IHI Open School | Wednesday, February 20, 2013

Editor’s Note: Colleen McCormick, a fourth-year medical student from Wright State University in Ohio, is using the IHI Open School Quality Improvement Practicum to conduct her first quality improvement project.

Every Wednesday during February and March, Colleen will write a blog post about her progress as a student trying to make a change in the health care system. You can read her first three posts here.


By Colleen McCormick, fourth-year medical student, Wright State University

After joining Dr. W’s project in the ICU, she invited me to an interdisciplinary meeting of nurses, social workers, and physicians to discuss our goals and plan of action: How could we (and why should we) increase utilization of palliative care in the ICU?

As described in my last post, palliative care has many benefits. However, there are also barriers to utilization of this medical specialty. Primarily, there are huge misconceptions about what palliative care really means. Many people (including physicians and nurses) associate palliative care with hospice care or with a withdrawal of care. Palliative care, rather, is about improving quality of life and quality of care, for both the patient and his/her family; it can even encompass treatment of a disease. Watch this video to learn more.

The hospital system where we are working has a palliative care team made of nurses and doctors — both were present at our initial meeting. They shared that they do receive consults from the ICUs in the hospital (medical, surgical, and cardiac ICUs). However, they feel that utilization could be higher, as they have seen the misconceptions I mentioned above in their day-to-day interactions with staff.

We also spoke with a charge nurse during the meeting who primarily cares for the medical ICU patients. She estimated that approximately 25% of her patients received care from the palliative care team, but also believed that more patients and families would benefit it. Even the physicians in the room felt they could do a better job in bringing palliative care to their patients, as they often underestimate the benefits that this service can provide.

All medical providers were now on board to make an improvement in the system. Once again, to get started, we needed a strong aim statement. While the data is still forthcoming, we estimate that the current utilization of this consult service in ICU patients is about 25%.

So, our goal is to increase utilization of the palliative care team for patients in the medical ICU from 25% to 50% by April 2013. Stay tuned to learn what we will measure and what we will change!

Has anyone out there done similar work around palliative care? I’d love to learn about it.

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