A Proposal to Restructure Hospital Care for Dying Patients

A restructuring of hospital care for dying patients is proposed through the introduction of a hospice-like alternative-care unit designed to provide palliative care to dying patients who have been transferred from the intensive care unit (ICU).

Abstract

Data from the recent Study to Understand Prognoses and Preferences\nfor Outcomes and Risks of Treatments (SUPPORT) indicate that the care of\nhospitalized dying patients continues to be inadequate. We propose a\nrestructuring of hospital care of dying patients through the introduction of a\nhospice-like alternative-care unit designed to provide palliative care to\ndying patients who have been transferred from the intensive care unit (ICU). \nBy functionally integrating these two modes of care, the hospital would\nlegitimize palliative care strategies for critically ill patients, help\npatients and their families clarify goals, and facilitate a process of shared\ndecision making concerning appropriate care. In addition, the link between\nlife-sustaining treatment and palliative care for dying patients would offer a\npromising opportunity to enhance medical education.