Palliative Care for Advanced Disease (PCAD)
Pathway: Unit Reference Manual
Online Registration Form
PCAD was prepared to guide the interdisciplinary management
of imminently dying inpatients. Please use our online
registration form to access the entire PCAD Unit Reference
Manual. Accompanying PCAD forms are presented in Adobe Acrobat
.pdf format. You will need the free Acrobat Reader application
to view and print these forms.
The Goals of PCAD are to:
consists of three components (forms are available in .pdf
for utilization of PCAD Pathway (See Flowchart below):
Step 1: Patient Identification
Identification of a patient that is likely to die during this
hospitalization (i.e., likely to die within minutes to days)
by any staff member. Any staff member or others listed may
suggest a patient for PCAD.
Step 2: Interdisciplinary Assessment
Interdisciplinary assessment of the patient for PCAD and discussion
with the primary healthcare provider The unit leadership
assesses the appropriateness of the patient for PCAD and initiates
an order for PCAD with the primary healthcare provider.
Step 3: Provider Clarification
Clarification of goals of care with the patient/family by
the primary healthcare provider The primary healthcare
provider clarifies the goals of care with the patient and/or
family and orders PCAD if end-of-life supportive care is the
primary goal of care.
Step 4: Implementation
The primary healthcare provider orders PCAD using the PCAD
Provider Order Sheet and rewrites the orders for the patient.
Nurses complete the demographic information on the PCAD Pathway
and initiate a PCAD Daily Patient Care Flowsheet.
Step 5: Discharge
The patient is discharged to an alternative care setting or
dies on unit. A family bereavement policy is initiated (e.g.,
condolence card and educational materials sent) and a staff
debriefing session is conducted.
now to access or download PCAD professional tools and