Problem: In an adult medical and surgical intensive care units (ICUs) at a Military Treatment Facility (MTF), palliative care (PC) consults were delayed. An April to December 2023 audit indicated only 10% of patients admitted were consulted to PC. Consults were ordered when patients were transitioned to comfort measures, no other medical interventions are available or after being transferred to other units. Patients and families admitted to the ICU have multiple unresolved symptoms, unrealistic expectations of prognosis and staff distress. Purpose: This quality improvement (QI) project aimed to increase PC consults among adult patients older than 18 years admitted to the medical and surgical ICUs by implementing a nurse-driven PC trigger tool. Method: The initiative was implemented over 15 weeks in Fall 2024. Implementation strategies included morning huddles, education, positive feedback, and ongoing communication. A team of stakeholders assisted with buy-in and implementation. Nurses accessed the QR code for the trigger tool placed on workstations and through the critical care intranet. If a patient met PC criteria, the nurse informed the physician, who then placed a consult in the Electronic Health Record (EHR) and notified the PC team. If PC criteria were not met on admission, the PC trigger tool was repeated if ICU stay was seven days or more or deterioration in clinical status. Results: The trigger tool was completed on 52.1% patients admitted. Of the 52.1% patients, 54.9% met the criteria and the physician’s placed consults on 69.4% of patients. The trigger tool was completed on 72.05% patients in the MICU and 27.4% patients in the SICU. Conclusion: Implementing the PC trigger tool significantly improved PC consults from 10% pre- implementation to 69.4% post-implementation of the PC trigger tool. However, sustainability has been challenging as the PC trigger tool is not incorporated in the EHR, which is an ongoing discussion with the informatics team. In the meantime, a HIPPA-compliant form will be used to complete the PC trigger tool in the ICUs. Continued leadership support, reinforcement, and education are imperative for the project's sustainability.