The Common Sense Guide to Improving Palliative Care > Caring for Caregivers > 6.2 Team Fairlawn
A number of physicians and nurses on the Geriatric Management Team and one activist nurse from the intensive care unit (ICU) at Fairlawn Hospital met regularly to discuss patients under their inpatient and clinic care and to try to understand how well their system was delivering care for advanced illness and the end-of-life. In the busy rush of day-to-day patient management, the team did not feel that they had a good sense of the quality of care being provided across their hospital or across the system's many delivery sites. They had experienced problems in a variety of areas: the lack of completed advance care plans for seriously ill and dying patients; families being ignored or avoided if there were conflicts concerning goals of care between clinicians and family members; and little patient and caregiver support in the community for discharged patients. The team decided to do something about these problems. After some discussion, they decided to start in the hospital, where they had some control over the setting. They wanted to offer more holistic care for their patients and caregivers, including clinical caregivers. The question, then, was: What to do and where to start?