113 Working together: fostering closer MDT working between palliative and intensive care teams to improve identification of unmet palliative care needs in ITU patients

<h3>Background</h3> Managing patients who are dying, often with high symptom burden, is important in ITU. An SPCT/ITU collaborative with SPCT senior involvement in weekly ITU MDT was established to improve earlier SPC input and decision making for patients. The impact of this intervention is described in terms of change in referrals, clinical practice and identifying service gaps. <h3>Methods</h3> Following the intervention of SPC consultant joining ITU MDT, (patient) referral numbers, demographics, outcomes, and data around what SPCT did was collected for 8 months post intervention and compared with same time period one year prior. Baseline ITU data also collected on all deaths. An online semi-structured survey to all SPCT/ITU staff was also created to identify current practice, and how this has changed since intervention with ideas for future improvement <h3>Results</h3> Data collected between October 2022–May 2023, and October 2023–May 2024. A 75% increase in referrals to SPCT team was observed in intervention period (28 vs 16), with increased referrals for pain management, psychological support, EOLC, staff and family support. Referrals for support with complex interventions, spirituality and advance care planning were observed in intervention group where there had been none cited in the control group. SPCT input led to greater support for medicines and CSCI management, withdrawal of life prolonging interventions, and complex family support. Online staff survey ongoing (n=23, 56% ITU, 36% Consultants). Average time in role 7 years. SPC Involvement valued and identified around patient/family communication, staff support &amp; medication advice. Challenges include timely referral of patients amid rapid deterioration, complex communications and changing from high dose IV medications to sc. <h3>Conclusion</h3> Closer working between ITU and SPCT has led to greater clinical input from SPC team with complex ITU patients, and a broadening of scope of support within the ITU setting.