The new study contradicts conventional wisdom that end-of-life care in the ICU is a poor experience for dying patients than care in other departments, according to Penn Medicine News. The study findings show that the elements of care in the ICU can be implemented to improve patient experiences in other departments. Measures such as higher staff rations can be implemented to improve end-of-care experiences, Penn Medicine News reported.
The researchers found that family members rated the ICU higher than other care departments in the categories of general care, pain management, communication, and spiritual and emotional support, according to Penn Medicine News.
“It has been assumed that dying in an ICU is even worse than a ward because it’s more expensive and more intensive. But that has never been based on any sound evidence,” senior author of the study Scott D. Halpern, a critical care physician and professor of Medicine, Epidemiology, and Medical Ethics and Health Policy in Penn’s Perelman School of Medicine, told Penn Medicine News.
The study also analyzed Veteran's Affairs records and results from the Bereaved Family Surveys, which are distributed to family members or close contacts of every veteran who dies in a VA institution.
“Instead of just looking at people who got all of their care in the ICU and people who did not, we looked at all people in the hospital,” Halpern told Penn Medicine News. “That actually provides the most compelling evidence that ICU care is associated with better end-of-life quality because we found that the greater the proportion of time spent in the ICU, the higher the quality of end-of-life care. It was a classic ‘dose-response’ relationship.”
The study suggested that features unique to the ICU, including lower staff to patient ratios, may be responsible for higher care satisfaction rates, Penn Medicine News reported.
In October, a group of Penn Medicine researchers created an algorithm to determine when patients with cancer likely to die within the next six months should begin end-of-life care conversations with their families.
In February 2019, the team behind the $1.5 billion construction of the Pavilion at the Hospital of the University of Pennsylvania altered its design plan to allow for easier room conversion and more rooms to be converted to ICU rooms.