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Next Reply: Re:Palliative Care and Case management
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Post Palliative Care and Case management
Author: GLuck
Date: Jul 27, 2008 7:21 pm
We have had a successful palliative care program for 4 years under nursing. There is now a push from administration to place program under case management where nurse will also team with case managers. The PC docs are concerned about a conflict of interest. In the past,we have had many families who have felt like the hospital was pushing them out the door. As a separate department, the PC doc is able to avoid any perceived conflict of interest. Does anyone have any comments regarding this situation? Note: The PC nurse is employed by the hospital and will be part of the case management team. The PC dotors are independent. Thanks
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Re:Palliative Care and Case management (by Weissman on 07/28/2008)
I can appreciate your unease. I'd be curious about the steps leading to the change. Was it part of operational restructuring and that's where PC seemed to fit best, or was it a deliberate recognition that PC could reduce LOS and thus belonged with DC planning? Having the PC nurse report through case management does not sound ideal--but the team's reputation and professionalism are typically more important in how they are perceived, than the operational location.

Of course, certain families will always think that the hospital is trying to push them out-no matter how you operate, with or without PC--it goes with the territory of mis trust between patients/families and "big" hospitals.
Fortunately, DC planning and PC are often well aligned with a focus on goal setting, the big picture and seeking the best discharge. On the plus side, you indicated your program was "successfull", which I am interpreting to mean that you are meeting the needs of your referring physicians and other staff, patients and families. Since you are already established, this should make things easier from an external perception standpoing. The PC team: docs and nurses, together with DC planning, should meet and discuss the situation and develop some operational standards for doing business.

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