P-112 Palliative care in ICU: A collective endeavour
Bibliographic record
Abstract
<h3>Background</h3> Despite considerable collective improvement efforts and clinical initiatives to integrate palliative and end-of-life care the intensive care unit (ICU), few patients are currently receiving palliative care in this particular setting as promoted by the World health organisation (WHO). <h3>Aim</h3> Our first study showed that three conditions promote the integration of palliative care in the ICU: sharing a common vision, a concerted decision-making process and a proper environment. In light of these findings, we developed, implemented and evaluated an intervention integrating these previously identified conditions. The purpose of this communication is to present our research process and its main results. <h3>Method and discussion</h3> An action research design was chosen for this study because this method is highly collaborative, values consensual decision-making process and provides an organisational structure allowing success and sustainability. <h3>Results</h3> The first phase of this study led to the development of a two component communication intervention: an interactive educational workshop and an interdisciplinary component, making the entire team and the patient active participant in the decision making. This intervention was implemented in the ICU and evaluated with a constructivist approach through a pilot-case study which offered an operational illustration of palliative care in the ICU through an integrative model. <h3>Conclusions</h3> This study clearly demonstrates that changing the culture of the ICU is a collective endeavour that could be empowered by action research process. Early proactive interdisciplinary rounds and regular patient-family meeting, improves successful goal-directed care, quality end-of-life care and satisfaction.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".