Advantages |
Expert input from interdisciplinary team of specialists
Expertise already exists, additional training unnecessary
Empirical evidence of benefit
Continuity of care before, during and after ICU
Facilitation of transfer out of ICU for end-of-life care, if appropriate
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Availability of palliative care for all ICU patients and families
Palliative care service not required
Clearly acknowledges importance of palliative care as core element of intensive care
Systematization of ICU work processes promotes reliable performance of palliative care
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Disadvantages |
Requires palliative care service with adequate staffing and other resources
Palliative care clinicians may be seen as “outsiders” in ICU
Consultants may lack familiarity with biomedical and nursing aspects of critical care
Activities of palliative care and ICU teams may overlap and/or conflict
Consultants must rapidly establish effective relationship with patients/families
Fragmentation of care may be compounded
ICU team may have less incentive to improve palliative care knowledge and skills
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Requires education of ICU clinicians in palliative care knowledge and skills
Depends on commitment of critical care clinicians and supportive ICU culture
Requires dedication of staff and other resources that may be lacking in ICU
Requires handoff to new team for post-ICU palliative care for patients who cannot benefit from or no longer need the ICU
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