We appreciate your dedication to providing timely and appropriate palliative care services to patients in the intensive care unit (ICU) and for your questions regarding our article. We agree that the use of the tool is central to achieving desired outcomes. Regarding your question about the use of the tool Monday through Friday, this timing was a noted process limitation in the unit where the research was being conducted. Full team ICU rounds only occurred Monday through Friday. However, the tool was completed by the bedside nurse 7 days a week. On the weekend, the results of the palliative care screening could be conveyed to the provider and a palliative care consult could be pursued.

In designing this process several years ago, we discussed the use of the tool to initiate an automatic palliative care consult. We noted that we had a blended...

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