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General Operational Topics

Next Reply: Re:Virtual Pall Care Unit
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Post Virtual Pall Care Unit
Author: LauraLathrop
Date: Mar 19, 2008 1:55 pm
Great, thought provoking presentation. Thank you.
Point to clarify: the deaths while in the PC beds are included in the hospital mortality rate?
Question: what is the reason that you do not convert the hospice appropriate pts while in hospital to hospice?
Replies: order by [Date] [Author] [Subject]
Re:Virtual Pall Care Unit (by CMartin on 03/20/2008)
I can't speak to the Virtual Unit clarification, but in Illinois, hospice is an outpatient benefit, and with currently only one exception in the state, not available in a hospice (resident) center (as exist in WI). Except for occasional short respite care stays, usually patients have to agree to not go back to the hospital for their life-threatening illness before a hospice will accept them. This effectively relegates hospice to home or nursing home. Referrals & initial contacts do occur in the hospital.
+ Re:Virtual Pall Care Unit (by Weissman on 03/20/2008)
Yes, our inpatient deaths are all included in hospital mortality data.

We don't convert patients to hospice who we expect will die in the hospital because:
a) most still have acute care needs
b) bringing in hospice services adds a whole new group of health professionals to the patient and family at a time right before death--leads to considerable confusion
c) our palliative care staff can provide the same services as hospice providers.

For patients in whom we believe dying is not imminent, we refer to home or residential hospice when possible.

David E. Weissman, MD
Professor & Director of Palliative Care
Medical College of Wisconsin/Froedtert Hospital
Palliative Care Leadership Centers
Re:Virtual Pall Care Unit (by rnielsen on 07/06/2009)
In Washington our palliative medicine group also runs the Hospice. The advantages of a virtual palliative care group is that:
1. you can develop a skilled group of RNs who can then influence care in the rest of the hospital.
2. The hospital is able to stop the DRG and get at least something for the hospice appropriate days. Our Hospice pays the hospital the GIP rate.
3. It removes those patients from the hospitals mortality statistics.
4. We don't have enough palliative medicine physicians to cover 24/7 so the Inpatient team remains the attending, but still, Our palliative care team can keep a closer eye on them.
5. It helps referrals.

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