Alternative Approach to the Care of Chronically Ill Patients at the End of Life in the Intensive Care Unit

Chronically ill patients in the final six months of life spend on average more days in the Intensive Care Unit (ICU) at New York University Hospitals Center (NYUHC) than nearly every highly ranked academic medical center within the United States. The Capstone team examined the utilization of the ICU in treatment plans for end of life patients at NYUHC in comparison to best practices and initiatives implemented at other New York City hospitals. Methodology included extensive research into the critical care literature, as well as analysis of qualitative and quantitative information from comparative academic medical centers throughout New York City. The Capstone team used the findings from the literature and peer institutions to develop recommendations for the NYUHC leadership to help them better address end of life care, including enhanced communication practices as well as revised ICU staffing structures and ICU admission procedures. The recommendations aim to improve the utilization of the ICU and the quality of care for chronically ill patients in the final few months of life.