Maintaining Quality of Life

By Deborah Bohr

Learn from your peers how to implement a palliative care program in your community

An aging population, greater life expectancy and the growing awareness of the importance of improving quality of life at the end of life have spurred hospitals and health systems around the country to launch new or expanded palliative care programs.

For someone with a life-threatening or life-limiting illness, palliative care aims to reduce or eliminate symptoms, promote well-being and provide psychological, social and spiritual comfort. More and more hospitals and health systems recognize the importance of maintaining quality of life in the weeks and months before death as part of their core mission.

Palliative care includes symptom management, psychosocial and spiritual support, negotiation of therapy goals, follow-up care, coordinated discharge planning, grief and bereavement support for families, and support to clinicians when patients die. Programs are sustained through the education of medical students and health care professionals, community education, and multidisciplinary research on death, dying and bereavement. Financial support comes from consultative service billing, grant funds and documentation of cases where cost savings have occurred. Among the excellent palliative care educational programs is the Hospital -Based Palliative Care Consortium, which is free of charge.

The Hospital-Based Palliative Care Consortium enables hospitals and health systems to visit successful palliative care programs. Managed by the Health Research & Educational Trust, HBPCC is funded by a grant from the Agency for Healthcare Research and Quality.

HBPCC selected learning labs based on their success in providing high-quality end-of-life care. Each program’s palliative care services differ in scope, management, organization and offerings, providing many options. Although based on a core curriculum, each site visit is tailored to fit participants’ unique needs. Geisinger Medical Center in Danville, Pa.; University of Pittsburgh; Palo Alto (Calif.) VA Health Care System; St. John’s Regional Health Center in Springfield, Mo.; Detroit Receiving Hospital; and Connecticut Hospice in Branford comprise the learning labs.

The HBPCC program has three phases. In Phase One, a hospital receives materials to evaluate its goals, strengths and weaknesses and to construct a customized site visit at the learning lab best suited to its needs.

Phase Two is the site visit, when the participating hospital learns first-hand about a successful palliative care program and how to transfer the information and approaches to its own situation. Participants receive a CD-ROM toolkit to help begin their own implementation.

During Phase Three, participating hospitals receive feedback and support as they implement their program. An HBPCC Web site provides updated information, announcements, tools and resources. An electronic learning community facilitates information sharing and support among participating hospitals, learning labs and project staff—all aimed at giving a high-quality end-of-life care to patients and their families. For more information, visit www.hret.org/hret/programs/palliative.html.

Deborah Bohr, M.P.H., is senior director, special projects, at HRET. Contact Deborah Bohr at dbohr@aha.org, or John Combes, M.D., principal investigator, at jcombes@aha.org.

This article 1st appeared in the December 2007 issue of HHN Magazine.

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