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

BACKGROUND: The shift from curative to palliative care is one of the most challenging situations in intensive care units.

AIMS: 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.

METHODS: 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.

RESULTS: Preliminary results obtained through individual interviews indicate participant satisfaction with the project, but additional data need to be gathered to evaluate improvements in practice.

CONCLUSIONS: Other collaborative quality improvement projects need to be implemented to improve end-of-life practices in intensive care units.