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CAPC Palliative Care Discussion Forum
Palliative Care Out-Patient Services

Next Reply: Re:outpatient palliative visits
Previous Message: Home palliative care visits
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Post outpatient palliative visits
Author: Habeca
Date: Aug 8, 2007 10:34 am

We are a Hospital based Hospice program and are starting an Outpatient palliative program. We are currenting in the hiring process for a CRNP to do Home visits. Is there any other programs out there willing to share, that are using a similar model. I am interested in documentation tools, advice on paper vs. computer programs, or dictation. Any help or advice in this area is greatly appreciated. We are working on an Inpatient program as well. Thanks.

Replies: order by [Date] [Author] [Subject]
Re:outpatient palliative visits (by Weissman on 09/05/2007)
Hello--sorry for the delay in responding. I would suggest you contact one of the three following hospice agencies that offer broad services (you can find contact info by Google search):

San Diego Hospice
Midwest Hospice and Palliative Care Center
Hospice of the Bluegrass

Please respond if these resources are unable to meet your needs.
Re:outpatient palliative visits (by janetbraun on 09/05/2007)
We have a palliative outpatient clinic and on rare occasions have done a home visit. If you would like to talk further, please let me know.

Janet L. Braun, RN, MSPH
Leadership Director
Palliative Care Center of the Bluegrass
Palliative Care Leadership Center
Lexington, KY
+ Re:outpatient palliative visits (by jackie on 09/16/2007)
We are a certified home care agency developing a cooperative program with one of our sponsoring hospitals. They have just established a palliative care program . Are you interested in any such arrangement?

The Hospital based program is offering training to the home care staff. In addition any patients identified as appropriate for palliative care, are referred to the in hospital staff via in-patient or ED contact. Recommmended treatment options are developed by hospital palliative care medical director and provided to primary care physicians as well as the home care staff..
would love to share our efforts to anyone interested......
+ Re:outpatient palliative visits (by dbz on 09/16/2007)
You might want to contact Hospice of Orange and Sullivan Counties. This is in New York State. I don't think they are doing home visits, though. I think a home health agency is able to bill for the services of a CRNP, but not a hospice. If the NP is working directly for the hospice, I don't think you can bill for her/his services. Where are you located?
+ Re:outpatient palliative visits (by Cloe3 on 10/30/2007)
My small catholic based hospital has been providing outreach palliative care services for over the last 6 years. It is a social worker based program - staffed by one social worker to make home visits to address the psycho-social issues of those struggling w/life-limiting illnesses. Over the past 6 years I have received over 800 referrals. I also see patients in the clinic setting when they are in to see their physician. We do not charge for palliative services as it is part of our catholic mission. Within the confines of this service, the primary care physician or oncologist and their nurse; the patient's clergy and myself make up the interdisciplinary team. It has been a wonderful program to fill the gaps between home health services and hospice. The people I work with- usually fall between these cracks. If they do qualify for home health, I take a step back until they are no longer involved although sometimes I work closely w/them. I also work very closely w/the county social workers. We try not to duplicate services and my specialty is helping the patient w/the medical issues and also ensure that the everyone is on the same page w/the same goals in mind. A majority of my patients are transitioned to hospice.

I also have an inpatient consultation program. I see an average of 20 patients inhouse every month and have an average of 15-20 patients in the outreach program. For the inpatient program, I work jointly with the discharge planners, and again, try not to duplicate services but ensure that everyone has a clear understanding of the goals of care.

Since I am a social worker I am not necessarily a threat to the physicians and they are my leading referral source. My inpatient "team" consists of the primary care physician, the patient's nurse for the day; staff spiritual services as well as the discharge planners; dieticians; therapists; etc.

I do have a medical director that I go to for information; advice; guidance; etc butI am the only palliative care staff person.

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