Partners in Palliative Care Program (Text Version)

Slide Presentation from the AHRQ 2008 Annual Conference

On September 9, 2008, James Lee, made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (302 KB).

Slide 1

Partners in Palliative Care Program

James Lee, MD
The Everett Clinic
Everett, Washington

Velda Filzen, RN, BSN, CHPN, Partners Program Coordinator.
Providence Hospice and Home Care Of Snohomish County.

Slide 2

What is Palliative Care?

• A philosophy of care:
  • Prevent and relieve suffering.
  • Quality of life.
  • Personal growth.
• An organized, highly structured care model:
  • Enhancement to disease-based treatment.
  • Assist with decision making.
  • Rendered along with life prolonging treatment, or as main focus of care.

Slide 3

Question.

• "Would you be surprised if this patient died in the next one to two years?"

Slide 4

Current Healthcare State—Crisis Management

• So, where do many patients today turn when they have a health crisis?
• The HOSPITAL.

Slide 5

One Solution: Palliative Care Program in Primary Care Office Setting

• Treatment options:
  • Based on patient's wishes and values.
  • Face-to-face or electronic communication (Electronic Health Record [EHR]).
• Proactively avoiding crisis:
  • Medical and social conditions addressed.
  • Office visits when appropriate.

Slide 6

Program Interventions

• Program Referral.
• Assessment.
• Volunteer.
• Chaplain.
• Care planning w/MD and patient/family.
• Case/Symptom Management.
• Monthly contact by phone or home visit.
• Documentation.
• Data collection.

Slide 7

Satisfactions Surveys for Partners Program

• Patients: Very High (4.8/5.0).
• Providers: Excellent (5.0/5.0).

Slide 8

2007—Hospice Utilization: Providence Hospice N=898; Partners Program N=63

The bar graph measures hospice utilization for "National (FY [Fiscal Year] '05)," "Providence," and "Partners."

• National (FY '05):
  • Average length of stay (LOS): 59.
  • Median LOS: 26.
• Providence:
  • Average LOS: 64.
  • Median LOS: 22.
• Partners:
  • Ave LOS: 90.
  • Median LOS: 86.

Slide 9

Hospital Admission Rate

The bar graph measures the "Partners Program-Hospital Admissions per Patient Month."

• 60 Days prior to death:
  • Partners (n=156): 1.27.
  • None (n=113): 1.34.
• 30 Days prior to death:
  • Partners (n=156): 2.9.
  • None (n=113): 3.5.
• Date Range: 8/4/04-10/30/06.

Slide 10

Our Goals

• To empower patients in managing their end of life care.
• To increase:
  • Primary care office case mgmt.
  • Patient/provider satisfaction.
  • Use of community resources.
  • Hospice and home health referrals.
• To decrease:
  • Unnecessary hospitalizations and emergency room (ER) visits.

Slide 11

• James Lee MD
  jlee@everettclinic.com
• Velda Filzen RN
  velda.filzen@providence.org