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Abstract

Background 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). Aim 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. Method and discussion 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. Results 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. Conclusions 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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