Proactive Identification of Palliative Care Needs Among Patients with COVID-19 in the ICU

Schoenherr, Laura; Cook, Allyson; Peck, Sarah; Humphreys, Jessica; Goto, Yuika; Saks, Naomi Tzril; Huddleston, Lindsey; Elia, Giovanni; Pantilat, Steven Z.

In the setting of the COVID-19 pandemic, new strategies are needed to address the unique and significant palliative care (PC) needs of patients with COVID-19 and their families, particularly when health systems are stressed by patient surges. Many PC teams rely on referral-based consultation methods that can result in needs going unidentified and/or unmet. Here we describe a novel system to proactively identify and meet the PC needs of all patients with COVID-19 being cared for in our hospital’s ICUs. Patients were screened through a combination of chart review and brief provider interview, and PC consultations were provided via telemedicine for those with unmet needs identified. In the first six weeks of operation, our pilot program of proactive screening and outreach resulted in PC consultation for 12 of the 29 (41%) adult patients admitted to the ICU with COVID-19 at our institution. Consultations were most commonly for patient and family support as well as for goals of care and advance care planning, consistent with identified PC needs within this unique patient population.