The Impact of a Neurocritical Care and Neuropalliative Collaboration on Intensive Care Unit Outcomes

Background: Neurocritical care (NCC) and neuropalliative care (NPC) clinicians provide care in specialized intensive care units (ICU). There is a paucity of data regarding the impact of NCC and NPC collaboration in smaller, community-focused settings. Objective: To determine the clinical impact of i...

Full description

Saved in:
Bibliographic Details
Published in:American journal of hospice & palliative medicine 2022-06, Vol.39 (6), p.687-694
Main Authors: Shemme, Andersen J., Phillips, Joel N., Bloise, Rafael, Koehler, Tracy J., Gorelick, Philip B., Francis, Brandon A.
Format: Article
Language:English
Subjects:
Cohort Studies
Hospital Mortality
Hospitalization
Humans
Intensive Care Units
Length of Stay
Retrospective Studies
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Neurocritical care (NCC) and neuropalliative care (NPC) clinicians provide care in specialized intensive care units (ICU). There is a paucity of data regarding the impact of NCC and NPC collaboration in smaller, community-focused settings. Objective: To determine the clinical impact of introducing a NCC/NPC collaborative model in a mixed ICU community-based teaching hospital. Design: Retrospective pre/post cohort study. Subjects: Patients ≥18 years of age admitted to the ICU who received neurology and palliative care consultations between September 1, 2015 and August 31, 2017 at a 300 bed community-focused hospital were included. Intervention: The addition of a NCC/NPC collaborative model took place in September of 2016. The time periods before (9/1/2015 to 8/31/2016) and after (9/1/2016 to 8/31/2017) the addition were compared. Results: A total of 274 admissions (pre: 130, post: 144) were included. There were significantly more NCC consultations provided in the post-period (44.6% vs 57.6%; P = .03). NPC consultation increased (55.4% vs 66.7%; P = .056) Median LOS was significantly shorter after implementation of the collaborative model (11 vs 8 days; P = .01). Median ICU LOS was also shorter by 1 ICU-day in the post-period, though this was not statistically significant (P = .23). Mortality rates were similar (P = .95). Conclusions: Our findings suggest NCC/NPC collaboration in a community-focused teaching hospital was associated with more NCC consultations, as well as shorter LOS without increasing mortality. These data highlight the importance of supporting collaborative models of care in community settings. Further research is warranted.
ISSN:1049-9091
1938-2715
DOI:10.1177/10499091211060055