147 Multidisciplinary collaboration to develop a tailored tool for identifying and considering ICU patient and family palliative care needs

<h3>Background</h3> Intensive Care Units (ICUs) aim to sustain vital functions in critically ill patients, yet global in hospital mortality for ICU patients is reported at 22% [5]. Physical and emotional distress is prevalent among patients and families, which palliative care aims to address. Despite known benefits, palliative care recognition in our ICU was perceived as suboptimal. <h3>Methods</h3> A multidisciplinary workgroup comprising ICU, surgical, medical, and palliative care professionals reviewed evidence and clinical practice to create triggers for identifying ICU patients who might benefit from palliative care. These triggers were retrospectively tested through case note reviews of patients who died in a tertiary ICU between January and July 2023, alongside matched survivors, to determine relevance. The final triggers informed the creation of a tailored tool for identifying patients with palliative care needs, and scenarios where specialist involvement may help. Acceptability scoping and iterative improvements were conducted over six weeks. <h3>Results</h3> From three workgroup meetings, 22 potential triggers were proposed. Retrospective review and a fourth meeting refined these to the most relevant triggers, including: ICU stay &gt;10 days, multi-organ failure, unplanned haematology/oncology admission or active malignancy impacting clinical status, withdrawal of ventilatory and/or renal support, expected in-hospital death, and ongoing deterioration/failure to progress in the opinion of the MDT. ICU staff wanted clear instructions and preferred use during morning huddles in addition to at the beside as needed. <h3>Conclusions</h3> Informed by prior research and multidisciplinary collaboration, a tailored ICU palliative care trigger tool was developed. The tool provides structured guidance aiming to facilitate earlier recognition and discussions around palliative care needs. Future work will assess the outcomes of the use of this tool prospectively.