The Christ Hospital Inpatient Palliative Care Consult Service Easing the Burden of Serious Illness

Palliative Care: Selection The Palliative Care Service fulfills The Christ Hospital’s commitment to patient- and family- centered care by partnering with patients, families and the primary medical team to manage the pain, symptoms, and stress of serious illnesses at any stage of disease. Through careful planning and attention to best practices, this project has garnered widespread acceptance and has demonstrated better than expected outcomes. This project demonstrates interdisciplinary teamwork at its best and serves as a model of projects within and outside the organization.

Palliative Care Service: Situation Analysis TCH had attempted to implement a palliative care program for two years but the project was not successful. The Ethics Committee found that it was overwhelmed with situations that would be best served by a palliative care service. Hospital stakeholders hoped that a robust interdisciplinary palliative care service would result in: –Decreased symptom distress and pain intensity –Decreased readmission rates and emergency department visits for the chronically ill –Decreased ICU length of stay

Palliative Care Service: Project Solution An interdisciplinary Palliative Care Steering Committee, led by the Chief Nursing Officer, spearheaded the project planning and recruited team members. During a two-month period of preparation, the TCH Palliative Care Team: –Conducted site visits to established programs to determine best practices. –Developed systems and technology to promote efficient work flow and evidence-based patient care. –Worked to build relationships with other health care professionals and provided education about palliative care.

Palliative Care Service: Results Higher than expected referral volume with majority of referrals coming from specialty services that had resisted palliative care in the past Decreased symptom distress and pain intensity Increased enrollment in hospice at the end of life Decreased urgent resuscitations (CPR) in cases of medical futility High percentage of palliative care patients completing advance directives High physician and staff satisfaction Decreased ICU length of stay Decreased readmissions and emergency department visits for the chronically ill