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Peer-reviewedCC BYHealthcare (Basel, Switzerland)

Trigger-Based Referral and Needs Assessment in the Intensive Care Unit: A Narrative Review and Conceptual Synthesis.

  • Majid Golestani1
  • Georg Bollig2
  1. 1Department of Anaesthesiology and Critical Care, Helios Klinikum Schleswig, St. Jürgener Straße 1-3, 24837 Schleswig, Germany.
  2. 2Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, 50924 Cologne, Germany.
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Abstract

Background/Objectives: Trigger-based referral systems are widely used to identify intensive care unit (ICU) patients who may benefit from palliative care, but the extent to which trigger status corresponds to multidimensional patient and family need remains uncertain. This narrative review examines trigger-based referral, needs assessment, and integrated approaches to ICU palliative care. Methods: PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and reference lists were searched, and a purposive thematic synthesis was conducted. The original identification-stage record counts were unavailable; selection was reconstructed from an archived full-text library, and screening was primarily performed by one author. Results: Trigger-based systems improved recognition of clinically vulnerable patients and several care processes. Direct evidence comparing trigger status with measured need is limited, however, and derives principally from one multicenter study using a family-member-reported NEST score. The literature supports distinguishing clinical risk from measured need but does not establish the superiority of trigger-based, needs-based, or integrated models. Conclusions: Current evidence supports comparative testing rather than adoption of any integrated configuration. Candidate components, timing, thresholds, feasibility, and applicability across healthcare systems require prospective evaluation.

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Cite

BibTeXRIS
BibTeX
@article{golestani2026triggerbased,
  title = {{Trigger-Based Referral and Needs Assessment in the Intensive Care Unit: A Narrative Review and Conceptual Synthesis.}},
  author = {Majid Golestani and Georg Bollig},
  journal = {Healthcare (Basel, Switzerland)},
  year = {2026},
  month = sep,
  doi = {10.3390/healthcare14193199},
  url = {https://europepmc.org/article/MED/42881637},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Trigger-Based Referral and Needs Assessment in the Intensive Care Unit: A Narrative Review and Conceptual Synthesis.
AU  - Majid Golestani
AU  - Georg Bollig
PY  - 2026
DA  - 2026/09/28
JO  - Healthcare (Basel, Switzerland)
DO  - 10.3390/healthcare14193199
UR  - https://europepmc.org/article/MED/42881637
AB  - Background/Objectives: Trigger-based referral systems are widely used to identify intensive care unit (ICU) patients who may benefit from palliative care, but the extent to which trigger status corresponds to multidimensional patient and family need remains uncertain. This narrative review examines trigger-based referral, needs assessment, and integrated approaches to ICU palliative care. Methods: PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and reference lists were searched, and a purposive thematic synthesis was conducted. The original identification-stage record counts were unavailable; selection was reconstructed from an archived full-text library, and screening was primarily performed by one author. Results: Trigger-based systems improved recognition of clinically vulnerable patients and several care processes. Direct evidence comparing trigger status with measured need is limited, however, and derives principally from one multicenter study using a family-member-reported NEST score. The literature supports distinguishing clinical risk from measured need but does not establish the superiority of trigger-based, needs-based, or integrated models. Conclusions: Current evidence supports comparative testing rather than adoption of any integrated configuration. Candidate components, timing, thresholds, feasibility, and applicability across healthcare systems require prospective evaluation.
SN  - 2227-9032
ER  -