title: Use of a supportive care pathway for end-of-life care in an intensive care unit: a qualitative study.
abstract: BACKGROUND
  Providing palliative care support in intensive care settings is beneficial, however, barriers to delivering high-quality end-of-life care remain. To address this, pathways have been used to improve the quality of palliative care in generalist settings. This study describes the views of health professionals using a supportive care pathway in intensive care.
  
  
  METHODS
  Qualitative semi-structured interviews were conducted with ten health professionals working in a surgical intensive care unit. The data were analysed thematically.
  
  
  RESULTS
  Participants were positive about the effect of the supportive care pathway on patient care, particularly in enabling consensus in care planning. Some expressed concerns including the difficulty of identifying the 'correct patients' for the pathway, the risk of it becoming a 'self-fulfilling prophecy', and a euphemism for dying.
  
  
  CONCLUSIONS
  Pathways are one potential mechanism for guiding care planning and communicating the goals of care to colleagues, patients and families, thus contributing to improvements in palliative care.
authors.affiliation: Consultant in Palliative Medicine, Birmingham St Mary's Hospice, UK.
authors.forename: Christina
authors.initials: C
authors.lastname: Radcliffe
authors.affiliation: Senior Lecturer, Department of Nursing, School of Health and Population Sciences, University of Birmingham, UK.
authors.forename: Alistair
authors.initials: A
authors.lastname: Hewison
mesh_terms: D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D010865:Pilot Projects; D036301:Qualitative Research; D013727:Terminal Care / Q000458:organization & administration*; D006113:United Kingdom
keywords: Intensive care; Intensive care unit; Palliative care; Patient care planning; Qualitative research; Supportive care