The core purpose of accountable care is to drive responsibility — accountability — to the provider and patient. Those providing the care and those receiving it must decide together what is beneficial, meaningful and, therefore, of the highest quality. It is up to the patient and family to weigh the value proposition and decide where the value lies for them.

To make care truly patient-centered, decisions must be guided by what the patients and their loved ones identify as “matters most.” Unfortunately, providers have rarely discussed the benefits and burdens of treatment in a meaningful way with patients — particularly the financial burden.

As political clashes continue over the Affordable Care Act, the important achievements that have emerged in recent years must not be lost. We must advocate more than ever that care be patient- and family-centered, and that all systems of care delivery support the time and effort providers need to genuinely discuss with individuals and their loved ones their preferences and goals of care.

Palliative care is particularly equipped for facilitating patient-centered care. By definition, palliative care is interdisciplinary, and the perspective of the team facilitates a more holistic assessment of the patient’s condition and needs. Unlike the traditional biomedical model of health care, palliative care takes a bio-psycho-sociol-spiritual approach. That includes sensitivity to cultural issues and how patients and their loved ones make decisions around treatments — and even about how health care discussions should be conducted.

Those skills aren’t restricted to the palliative medicine specialist. As with other disciplines, palliative care specialists share their knowledge and skills with all physicians and health care professionals. Discussions between the palliative care professional and the treating physician are particularly helpful in promoting frank discussions with patients and loved ones about care preferences and the burden and benefit of treatments.

This July in San Francisco, we will celebrate the 16th Circle of Life Award for Innovations in Palliative and End of Life Care. Award winners have provided us with examples of innovative programs that effectively deliver patient- and family-centered care to the sickest of the sick and demonstrate the vital impact of team-based care: collaboration, communication and coordination of care delivery.

As we all work to create better systems of care delivery and to keep the focus on patients and their loved ones, the innovative work of palliative care programs across the country are a valuable resource. We look forward to sharing the winners’ stories and celebrating their successes. We also look forward to the next round of applications that will begin this summer and the wealth of knowledge and experience these will bring. 

Martha L. Twaddle M.D., FACP, FAAHPM, is senior vice president of excellence and innovation at JourneyCare, associate professor of medicine at Northwestern University School of Medicine and chief medical officer of Aspire Health–Illinois.


News from the AHA

June 1 deadline to apply for Transformation Fellowship

Senior health care leaders may apply through June 1 to participate in the next AHA Health Care Transformation Fellowship, a nine-month program designed to give participants knowledge, tools and connections to transform their health care organizations. Through in-person learning retreats, webinars, one-on-one coaching and peer-to-peer networking, participants learn how to lead their hospital organizations in improving care while lowering costs. Curriculum topics include clinician alignment and leadership; new care delivery models; population health management; integration of health information technology; and evolving partnerships with payers, employers, community organizations and others. For more information, visit www.hpoe.org/hctfellowship.

AONE presents Lifetime Achievement Award

The American Organization of Nurse Executives in May presented its 2015 Lifetime Achievement Award to Kathleen Bower, R.N., principal emeritus of the Center for Case Management in Wellesley, Mass. Bower spent more than 40 years in nursing leadership. Also receiving awards were: Deborah Washington, director of diversity patient care services at Massachusetts General Hospital, Boston, AONE Prism Diversity Award; Col. Laura Feider, chief of the department of nursing science at the Army Medical Department Center and School, Joint Base San Antonio, Fort Sam Houston,Texas, AONE Mentor Award; and the Organization of Nurse Leaders of Massachusetts & Rhode Island, AONE Chapter Achievement Award.

Hospitals join White House worker training initiative

About 100 employers, including hospitals, have committed to increasing access to training opportunities for front-line workers through a presidential initiative to help workers advance their skills and wages, the White House announced last month at a summit on the Upskill Initiative. For more information, www.whitehouse.gov