title: Integrating palliative care in the ICU.
abstract: OBJECTIVE
  Although providing palliative care in the ICU has become a priority, the success of different methods to integrate palliative care into the ICU has varied. This review examines the current evidence supporting the different models of palliative care delivery and highlights areas for future study.
  
  
  RESULTS
  The need for palliative care for ICU patients is substantial. A large percentage of patients meet criteria for palliative care consultation and there is frequent use of intensive care and other nonbeneficial care at the end of life. Overall, the consultative model of palliative care appears to have more of an impact on patient care. However, given the current workforce shortage of palliative care providers, a sustainable model of delivering palliative care requires both an effective integrative model, in which palliative care is delivered by ICU clinicians, and appropriate use of the consultative model, in which palliative care consultation is reserved for patients at highest risk of having unmet or long-term palliative care needs.
  
  
  CONCLUSIONS
  Developing a mixed model of palliative care delivery is necessary to meet the palliative care needs of critically ill patients. Efforts focused on improving integrative models and appropriately targeting the use of palliative care consultants are needed.
authors.affiliation: aDepartment of Anesthesiology, Columbia University, New York, New York, USA bDepartment of Critical Care Medicine, Sunnybrook Hospital cDepartment of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
authors.forename: May
authors.initials: M
authors.lastname: Hua
authors.forename: Hannah
authors.initials: H
authors.lastname: Wunsch
mesh_terms: D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010166:Palliative Care; D058996:Quality Improvement; D013727:Terminal Care