Palliative care is patient and family-centred care which offers to provide comprehensive support to patients with a terminal illness, focussing on relief and management of distressing symptoms and on improving overall quality of life for patients and their families. Intensive care units (ICUs) are a unique setting in this context. The dominant culture in the ICU is about prolonging life and supporting failing organ function. Given Europe’s ageing population, ICU patients are becoming older and sicker. About 13% of patients in European ICUs receive end-of-life care.
A modern understanding of palliative care in ICU means supportive care that is initiated early and that accompanies organ-sustaining measures for all severely ill patients, not only those who face imminent death. However, palliative care is not well integrated into European ICUs. There is a lack of practice standards which is reflected in a high variability of practice among countries, regions and even within a single ICU.
Previous studies have identified deficits in current palliative care practice in ICU, including problems with communication and shared decision-making. While ICU physicians often consult with medical experts from other fields such as neurology or cardiology to assist in complex clinical situations, they hesitate to call in palliative care specialists. There is a lack of knowledge about the benefit of early specialist palliative care consultation. Moreover, in many European ICUs, palliative care specialists are not available on site.
The main goal of EPIC (Enhancing Palliative care in ICU) is to provide early and high-quality access to palliative care in the ICU. The EPIC project aims to contribute to this goal by
- Implementing a European standardized model of palliative care in ICU
- Using novel measures like telemedicine, checklists and customized staff education to provide easy and early access to palliative care
- Generating evidence for policymaking and legal frameworks
- Providing European ethical guidelines for telemedical palliative care
