Implementing Palliative Care across the life span

Abstract

Session presented on: Saturday, November 16, 2013: The palliative care service line at our 735 licensed bed facility recently received palliative care (PC) certification through TJC. Moving forward, our newly unified service line quickly learned that 2 diverse PC teams, adult PC and perinatal PC, must form an unlikely partnership. Our overarching goal for seeking certification is to provide patients in need with the augmented care PC services offers. We examined the percentage of deaths in the adult ICUs with and without PC services; examined the percentage of family conferences that established goals, were multidisciplinary, and had both elements; determined the 'likelihood to recommend PC services' through a PC-specific patient satisfaction tool; and developed, implemented, and determined the use of triggers to appropriately identify neonatal PC patients. The aforementioned concepts afforded our program the opportunity for continued growth. The most pervasive measure impacting our administrative support lied within integration of PC services in the patients that die in the ICU, which is also the most impactful for judicious financial use for our health care system. Obstacles encountered included hospital wide staff education and preparation, differentiating between PC and hospice services, and process refining with our prenatal PC patients. Our future plans encompass examining the financial ramifications of cost-avoidance, constructing a process for automated PC involvement in patients admitted under the hypothermia protocol, and we are awaiting IRB approval for a quasi-experimental design study in the ICU.