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Palliative Care Out-Patient Services

In Reply To: Outpatient PC service for managed care patients
Next Reply: Re:Re:Outpatient PC service for managed care patients

Post Re:Outpatient PC service for managed care patients
Author: SharolHerr [CAPC/PCLC Faculty]
Date: Jun 23, 2008 4:55 pm
I don't think that providing outpatient palliative care is impossible but... If you are starting your acute palliative care service be cautious not to take on more then you have resources to do as you grow. There is a tremendous need for palliative care in hospitals and the saying, "Build it and they will come" is so true. I would encourage you to look at other ways initially you can assure there is appropriate post-hospital follow-up without immediately trying to develop an outpatient program. Some of those strategies are: good communication with the primary physician in the outpatient setting, referral to appropriate agencies such as hospice and home care, comprehensive and thoughtful continuity of care information that is mindful of the change in environment from acute to outpatient care, etc. Best wishes with your start up. Sharol Herr, RN, MSEd, CHPN; Nurse Clinician/Education Coordinator; Mt. Carmel Health Palliative Care Leadership Center; Columbus, Ohio.
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+ Re:Re:Outpatient PC service for managed care patients (by lbogmd on 06/24/2008)
Thanks for your input. I understand what you are advising, but let me add that we already have a "Transitions" program in place, where a social worker and volunteer are assigned to "pre-hospice" patients (shortcut term, sorry), and I frequently visit them to provide medical follow-up. It isn't too much of a stretch to add nursing and spiritual care to provide a comprehensive outpatient palliative care model. I DO hear your concern about the possibility of overwhelming volume, and I too am aware of that possibility. At this point, we are prepared to add staff through the joint efforts of our hospice's and the hospital's HR directors. Thanks again. We'll be in touch!
Re:Re:Outpatient PC service for managed care patients (by kellykomatz on 06/24/2008)
I work as a pediatrician and bridge across both inpatient and outpatient work. I am not sure what your individual position is - but when a patient is in the outpatient setting frequently the primary physician will consult "me" for pain and symptom managment. That way, when I make a home visit and assessment I can bill for the services. I write a note reflecting the consult - who - why - report back and send a copy back to the referring the physician. Also, through your transitions program if someone identifies a need the team member could perhaps talk to the primary/community physician. Best of luck - Kelly Komatz

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