Domain 7 - Emotional & Organizational Support for ICU Clinicians

  • Support health care team colleagues caring for dying patients:
    • Inform team members about the imminent death of a patient to increase sensitivity and awareness.
    • Assist colleagues caring for dying patients by assisting in the care and/or management of that colleague's other patient care responsibilities.
    • Offer colleagues a break or respite following the death of a patient they had cared for.
  • Adjust nursing staffing and medical rotation schedules to maximize continuity of care providers for the dying patient.
  • Communicate regularly with interdisciplinary team regarding goals of care:
    • Develop interdisciplinary rounds.
  • Establish a staff support group, based on the input and needs of ICU staff and experienced group facilitators, and integrate meeting times into the routine of the ICU:
    • Assist colleagues with grieving and feelings of loss after patients' deaths by formally or informally acknowledging their feelings and taking time to engage in debriefing sessions.
    • Ensure that ICU staffing schedules allow for flexibility and understanding if caregivers become overwhelmed when caring for dying patients and their families.
  • Enlist palliative care experts, pastoral care representatives and other consultants to teach and model aspects of EOLC:
    • Develop pathways to facilitate consultation with palliative care experts, pastoral care representatives and other consultants to maximize palliative care.
  • Facilitate rituals for the staff to mark the death of patients.

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families.