Every year, more than 5 million patients are admitted to the intensive care unit (ICU) and an average of 55 000 ICU patients are being cared for daily across the United States. Indeed, 20% of all hospital deaths are associated with an ICU stay within the final 3 days of life.2–4  The number of patients admitted to the ICU is expected to rise as our aging population continues to increase. The neurologic intensive care unit (NICU) often admits many patients with abrupt and devastating diagnoses or injuries. The plan of care for these patients can quickly change from aggressive, life-prolonging measures to end-of-life care when the diagnosis and prognosis become clear. NICU staff at the University of Florida Health Shands Hospital became concerned with a lack of formal structure and support within their unit to deliver high-quality palliative, hospice,...

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