This July, we celebrate the 15th Circle of Life Award presentation at the Health Forum and AHA Leadership Summit in San Diego. The field of hospice and palliative care has come a long way in these 15 years. The Circle of Life Committee, comprising leaders and innovators from all disciplines, has reviewed and visited some of the most innovative programs. The vision of what palliative care can and should be has evolved greatly and what was innovative in 2000 has become routine in 2014. The award and the recognition it facilitates plays a key role in the advancement of the field and making sure these innovations take root and are replicated.
Now in 2014, there is a consistent emphasis on the continuum of care, care transitions and the management of patients with advanced serious illnesses upstream from end-of-life care — as well as innovative partnerships between hospitals, community-based agencies and ambulatory services — to create seamless support across sites of care.
Palliative care plays a particularly important role for patients with progressive illnesses and declining function who often get caught in the vortex of health care consumption. These are the 10 percent of our health care population whose escalating needs compel them to utilize the hospital and emergency department for lack of better alternatives.
Palliative care services that create a continuum of support from the acute care hospital to skilled care facilities to home-based care play a vital role in accountable care organizations, patient-centered medical homes, and within payer coverage benefits and population health management initiatives. For the first time, payment structures are aligning to support palliative care beyond the hospital setting.
The committee sees many opportunities ahead. Evidence shows that cancer patients who use palliative care support plus routine care earlier have improved symptom management and higher quality of life, and live longer. We look for evidence-based practices in symptom management, and for physicians and advanced practice nurses with communication skills to effectively facilitate primary palliative care discussions as well as to identify patients and families for whom specialty-level palliative care is warranted.
We look for programs that have developed supportive services for traditionally underserved populations. These include racial and ethnic minorities, children with chronic illnesses living into adulthood, and people with cardiac, pulmonary and neurological conditions that are advancing yet are still many months, if not years, from the end of life.
There will be an increasing need for the delivery of early palliative care services to those with serious and progressive illnesses and a rapidly evolving push to move palliative care beyond the acute hospital into the community. This will require innovative partnerships and evidence of close cooperation among organizations with common interests, demonstration of shared patient and family management, aligned incentives and integrated outcome measurements. It also will require partnerships among many institutional services, physician practices, clinics, academic institutions, formal and informal senior living communities, and community service programs and agencies.
What is your program doing that is innovative and contributes to this evolving field? Please share your stories and experiences by applying for the 2015 Circle of Life Award at www.aha.org/circleoflife and read, be inspired by and use the innovations shared by the 2014 honorees published in the August issue of Hospitals & Health Networks.
Martha L. Twaddle, M.D, FACP, FAAHPM, is chairman of the Circle of Life Committee and chief medical officer of the Midwest Palliative & Hospice CareCenter, Glenview, Ill.
News from the AHA
Paper focuses on 'appropriate' use of medical resources
The "Appropriate Use of Medical Resources" white paper identifies some of the drivers of health care utilization and its contributing factors. More importantly, the paper recommends a way to move forward that will place hospitals at the forefront of innovative change for reducing nonbeneficial services while improving health care overall. For instance, the AHA has developed a Top 5 list of hospital-based procedures or interventions that should be reviewed and discussed by a patient and physician prior to proceeding. Hospital executives can share the white paper with the board, medical staff and community leaders and use an accompanying discussion guide to further explore the topic. In the coming months, the AHA will roll out resources targeting each of the five procedures or interventions, as well as best practices from hospitals and health systems that are already in this path. Visit www.aha.org.
Monograph explores board's role in philanthropic fundraising
A monograph from the AHA's Center for Healthcare Governance discusses the important role that philanthropy can play for hospitals and how governing boards and foundation boards can work together to increase the impact of charitable giving on the organization's mission. It includes tools to help boards define their role participating in and overseeing philanthropic activities, such as talking points for approaching potential donors and sample metrics for monitoring fund development goals. Visit www.americangovernance.com.
Quality improvement forum for hospital leaders, caregivers
The AHA launched a new forum, called the Symposium for Leaders in Healthcare Quality, to provide both hospital leaders and front-line caregivers who engage in performance improvement activities a setting to collaborate and share best practices. SLHQ members have access to research and education, professional development opportunities and a peer-to-peer learning network. Visit www.aha-slhq.org.