Improving end-of-life care in an intensive care unit: a collaborative quality improvement project.

Abstract

The shift from curative to palliative care is one of the most challenging situations in intensive care units. The purpose of this collaborative project was to develop and implement a pilot intervention aimed at improving end-of-life care for patients in an open intensive care unit in Quebec City, Canada. Individual and group interviews were first conducted to identify strengths and needs for improvement in care. After the main needs for improvement were determined, interventions were implemented in a concerted manner. These included training in end-of-life care as well as the adaptation of tools to promote communication with the patient and his or her family, or to facilitate interdisciplinary work. Preliminary results obtained through individual interviews indicate participant satisfaction with the project, but additional data need to be gathered to evaluate improvements in practice. Other collaborative quality improvement projects need to be implemented to improve end-of-life practices in intensive care units.