A few weeks ago, I wrote about a new initiative by the Center to Advance Palliative Care called Improving Palliative Care in Emergency Medicine in the context of an article I'm working on for an upcoming edition of H&HN on the increasing emergence of palliative care treatment and consultation in the acute care setting.


Afterwards, I heard from the Greater New York Hospital Association, which recently launched the Palliative Care Leadership Network to help its members discuss and share ideas around hospital-based palliative care. Lorraine Ryan, senior vice president for the GNYHA, noted that the association's members have taken varying approaches to palliative care, and are at a different stages of development, creating the need for a system of information sharing.

"We wanted to create a forum where leaders in palliative care could come together, and share best practices," Ryan said.

While most of the network's conversations to date have been informal, the group is now working on a smaller collaborative to develop a palliative care bundle addressing three major aspects of care: identifying patients for whom palliative care services may be appropriate, creating broad strategies for treatment options and developing measurements to document compliance with these tools.

"It's having a standardized protocol for contemplating the needs of these types of patients," Ryan says.

Much of the specifics of the protocols, however, will be left up to individual providers, noted Sara Kaplan-Levenson, GNYHA's project manager. For instance, details like where patients should be assessed for palliative care needs might range from the ED to the ICU, and their ultimate destination could range from a hospital room to community-based care at home.

"There will be some initial point of transition, but the treatment element is unlikely to be particularly prescriptive," Kaplan-Levenson said.

As it happens, GNYHA's efforts are coming at the same time two New York State laws, the Palliative Care Information Act and the Palliative Care Access Act, take effect. The first law requires hospitals to offer palliative care informatio to terminally ill patients; the second requires providers to "facilitate access to appropriate palliative care consultation and services."

Ryan, who notes that GNYHA and member hospitals were already moving toward their efforts when the laws were passed, says the laws do not include specific regulations and should help encourage hospitals to experiment with palliative care without pushing specific strategies.

"This will help steer providers in the right direction," Ryan says. "It sort of endorses the belief that this is an appropriate way of approaching certain types of patients that didn't exist before."

I'll be watching these initiatives closely as I continue to research the emergence of hospital-based palliative care, and I'm interested from hearing more on other grassroots, palliative care initiatives. Is your hospital or region launching an initiative around palliative care? Email me at hbush@healthforum.com.

Haydn Bush is the senior online editor for Hospitals & Health Networks magazine.