Upon systematic review of 37 published studies, a team of researchers led by Dr. Rebecca Aslakson of Johns Hopkins University (Baltimore, MD) found promising results when palliative care was provided as part of a patient’s treatment:
• ICU length of stay decreased in 13 of 21 studies (62%)
• Hospital length of stay decreased in 8 of 14 studies (57%).
The team also looked at whether there was any difference in outcomes when palliative care was provided solely by trained members of the ICU (an integrative model) versus palliative care that was provided by “outsiders into the ICU” who were brought in to assist (a consultative model).
In the studies that used an integrative model, ICU length of stay decreased in four of nine studies (44%), while hospital length of stay decreased in two of five studies (40%).
In the studies that used a consultative model, ICU length of stay decreased in nine of 12 studies (75%), while hospital length of stay decreased in six of nine studies (67%).
While the outcomes from the consultative model appear to be more effective, Dr. Aslakson cautions that one model isn’t necessarily better than the other, noting that integrative care can be much more difficult to provide in open or semi-open ICUs that have “40 different doctors floating around.”
She recommends that hospitals look at their unit, the way it works, and who the providers are. Then consider the literature and what might work for their unit.
To learn more about the team’s findings, see The Oncology Report.