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CAPC Palliative Care Discussion Forum
Designing a Program

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Post Stuck!
Author: szaglifa
Date: Jun 23, 2009 9:06 am
Is there a "C.H.I.P.S" program in New England? I was in cohort 1 way back when in San Francisco, and have now relocated to a small community hospital. I am charged with getting a palliative care team up and running out here, but there really is no practical "buy in" from senior management/MD's. I have used all of the CAPC tools to state the case, but I can't get anyone to put their $ where their mouth is and bring in a palliative care MD. So, we have an interdisciplary team led by me (a social worker), and no MD/APRN! So weird. Finances seem to be the crux...everyone hears that palliative care is cost effective, but it's not changing practical matters. Advice??
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Re:Stuck! (by SharolHerr on 06/23/2009)
I'm not familiar with a "C.H.P.S" program in New England. One of the things we have learned is that physicians want to be led by physicians. If you were able to find a physician champion then perhaps they could help you move the agenda forward, even if they aren't the one who would be the palliative doc. You may even consider seeing if there is a local hospice program that would be interested in co-oping to start a program or share physician hours. My guess is that you will need to see where you can get your department head or VP to budge and then build momentum and buy in.

I recommend the following article published last fall which has sound numbers to reflect the financial benefit of palliative care: "Cost Savings Associated With US Hospital Palliative
Care Consultation Programs," R. Sean Morrison, MD; Joan D. Penrod, PhD; J. Brian Cassel, PhD; Melissa Caust-Ellenbogen, MS; Ann Litke, MFA; Lynn Spragens, MBA; Diane E. Meier, MD; for the Palliative Care Leadership Centers’ Outcomes Group; Arch Intern Med. 2008;168(16):1783-1790.

Now that Palliative Physicians will be recognized as a specialty in October by Medicare, I think the field will also gain some clout and increasing representation at the table. You may also want to tap into the case management department to determine where your cost outliers are as well as the DRG's that are the top ten admissions to your facility. Patients with frequent admissions and ED visits are also attention getters. I hope you are able to move forward soon. There is tremendous potential for the impact you can have with a
complete IDT.

Sharol Herr, RN, MSEd, CHPN
Nurse Clinician and Education Coordinator
Mount Carmel Health Palliative Care Leadership Center
Columbus, Ohio

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