Academic medical centers now have an exciting opportunity to secure their status as national leaders in the emerging specialty of palliative care.

Building Academic Palliative Care is a new in-depth training program developed by three academic Palliative Care Leadership Centers (PCLC) firmly established in palliative care research, education and clinical service – Medical College of Wisconsin, University of California, San Francisco and Virginia Commonwealth University.

This specialized training offers academic teams the chance to provide a palliative care program that:

1. Promotes faculty development in palliative care,
2. Brings crucial clinical experience to students and residents, and
3. Works to better integrate the academic mission within the teaching hospital.

Training is provided on-site at any of the three participating PCLC academic medical centers, or a PCLC team can come to you at your institution. (See our website for details.)

Medical College of Wisconsin
April 17-18; May 22-23; August 21-23; October 16-18; December 6-8

University of California, San Francisco
April 3-4; September 14-15

Virginia Commonwealth University
September 18-19; November 13-14

Questions? Contact Matthew Henry, PCLC Program Coordinator, (212) 201-2683 or matthew.henry@mssm.edu. To register or to learn more, please click here.

Palliative Care Leadership Centers (PCLCs) training will help you fast-track your palliative care program through two-days of on-site, hands-on training and a full year of follow-up mentoring. Attend one of six PCLCs and learn from the experience of established palliative care programs how to finance, design, market and operate a successful program.

CME credit is available for physicians.
Nursing and Social Work credits pending.

To learn more about this initiative, visit www.capc.org/pclc. For more information about individual PCLCs, click on their name below. We encourage you to register soon. Sessions are available on a first-come, first-served basis.

Fairview Health Services – Minneapolis, MN
June 14-16

Massey Cancer Center of Virginia Commonwealth University Medical Center – Richmond, VA
April 24-25*

Medical College of Wisconsin – Milwaukee, WI
April 17-18*; May 22-23

Mount Carmel Health System – Columbus, OH
April 20-21; May 18-19

Palliative Care Center of the Bluegrass – Lexington, KY
April 5-6

University of California, San Francisco (UCSF) – San Francisco, CA
April 3-4*; September 14-15*

*Sessions marked with an asterisk (*) are also part of the new Building Academic Palliative Care training program.

CAPC interactive audio conferences offer participants practical information about the structural, operational and financial aspects of developing and sustaining palliative care programs. Mark your calendars for these upcoming Audio Conferences:

Oncology Nursing and the Treatment of Pain
April 11, 2006
1:30 - 2:30 PM Eastern
10:30 - 11:30 AM Pacific

Featured Speaker:

• Patrick Coyne, MSN, APRN, BC, Clinical Director, Thomas Palliative Care Unit Massey Cancer Center of Virginia Commonwealth University

Hospitalists and Palliative Care:
A Win-Win Partnership
May 18, 2006
1:30 - 2:30 PM Eastern
10:30 - 11:30 AM Pacific

Featured Speakers:

• Steve Pantilat, MD, Associate Professor, University of California, San Francisco; Director of Palliative Care Service, University of California Medical Center, San Francisco
• Eva Chittendon, MD, Assistant Clinical Professor of Medicine, University of California, San Francisco

The following are recent news items and upcoming events from our palliative care colleagues. CAPC provides a timely listing of upcoming events related to palliative care on our Web site. To view the full calendar, please click here.

National Hospice and Palliative Care Organization (NHPCO) Events
Please see NHPCO website for general information.

7th Clinical Team Conference and Scientific Symposium, April 26-28, 2006, Town and Country Resort, San Diego, CA, www.nhpco.org/ctc2006

5th National Conference on Hospice and Palliative Care — Volunteerism and Caregiving, July 28-30, 2006, Denver, CO, www.nhpco.org/vol2006

21st Management and Leadership Conference, September 11-13, 2006, New York, NY, www.nhpco.org/mlc2006

The American Academy of Hospice and Palliative Medicine (AAHPM)
AAHPM is proud to announce the availability of PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care), a new electronic publication that each month provides palliative care clinicians with concise summaries of important findings from more than 30 medical and scientific journals. This resource helps geriatricians, oncologists, pain specialists, and others interested in end-of-life care to stay on top of the latest research in the field, and its relevance to clinical practice.

To join the Academy, or sign up for a complimentary subscription to PC-FACS, visit www.aahpm.org/membership/PC-FACS.

End-of-Life Nursing Education Consortium (ELNEC)
April 19-21, 2006: ELNEC-Core in Kansas City, MO

August 2-4, 2006: ELNEC-Pediatric Palliative Care in Anaheim, CA

October 12-14, 2006: ELNEC-Core in Washington, DC

November 13-15, 2006: ELNEC-Critical Care in Pasadena, CA

For more information and/or applications on the ELNEC project, please visit www.aacn.nche.edu/ELNEC.

Call for Abstracts
The American Academy of Hospice and Palliative Medicine (AAHPM), in collaboration with the Hospice and Palliative Nurses Association (HPNA), will host its Annual Assembly February 14-17, 2007, in Salt Lake City, UT. The first call for workshop and concurrent session presentations will open March 15–May 1, 2006. The second call for case studies, papers, and posters, will open on June 15–July 17, 2006.

For more information visit the AAHPM Web site at www.aahpm.org.

Become an EPEC Trainer
Sponsored by The EPEC Project: Education in Palliative and End-of-Life Care, this two and one-half day conference will provide the basic tools you will need to become an EPEC Trainer. Master facilitators and national experts in palliative care will present four plenary and 12 interactive small-group sessions.

June 23-25, 2006
Seattle, Washington Hyatt Regency Bellevue

Please visit the EPEC Web site for more information or to register.

It is difficult for anyone in an intensive care unit (ICU), whether patient, family member or professional, to contemplate the patient dying, explains Dr. Judith Nelson, critical care and palliative care physician at Mount Sinai Medical Center and a leader in several national initiatives aimed at improving end-of-life care in the ICU. Barriers to progress in this area reflect the ICU’s intensive focus on rescue and on preserving life.

On March 2, Dr. Nelson presented a CAPC audio conference, “Palliative Care in the ICU: Spotting and Surmounting the Obstacles,” offering preliminary results from a recent survey of ICU nurse and physician managers conducted by the Robert Wood Johnson Foundation’s Critical Care Peer Work Group.

Obviously, people die in ICUs—over 500,000 per year during or soon after an ICU stay, the majority of them following a decision to withhold or withdraw some form of life-sustaining treatments. “We want to understand why end-of-life care remains suboptimal, even though it is a priority for professional groups,” Nelson says. Challenges to be overcome include:

• Prognostic uncertainty—which of the ICU’s seriously ill patients will end up living or dying;
• The incapacity of most ICU patients, coupled with the ICU’s emphasis on promoting patient autonomy;
• Unrealistic expectations by both family members and clinicians; and
• Inadequate communication.

These challenges would suggest opportunities for palliative care to help the ICU team. But before that can happen, the palliative care team needs to learn the language and culture of the ICU and earn its trust. “It’s really a different world, with different patients, a different knowledge set, a whole different way of looking at care,” Dr. Andrew Billings of the palliative care service at Massachusetts General Hospital stated in the most recent “Notes from the Field” column in the Journal of Palliative Medicine (1).

Billings’ service received one of four ICU/palliative care grants from the Robert Wood Johnson Foundation’s Promoting Excellence in End-of-Life Care in 2003. The four projects, described in the JPM column, took various approaches to injecting palliative care into ICU practice, although three basic models have emerged from their experience:

• An established hospital palliative care service that offers consultations to ICU staff for assistance with difficult or time-consuming cases;
• An ICU team that commits itself to learning and integrating palliative care concepts into routine practice; and
• A combined or hybrid approach, which recognizes that neither the external nor the internal model can address all patients’ needs.

“Answers in your hospital are likely to be institution- specific,” Nelson told the CAPC audio conference. Success also requires integrating palliative care into the treatment of all ICU patients, including those still seeking life-prolonging treatments, rather than viewing it as a sequel to intensive care. Otherwise, palliative care will be deferred until it is too late. Among the specific strategies viewed as helpful in Nelson’s ICU survey are:

• End-of-life care quality monitoring;
• Bereavement programs for families;
• Regular, interdisciplinary family meetings; and
• Training in end-of-life communication.

Unfortunately, access to these strategies is not as widely available in contemporary ICUs as their recognition by ICU professionals might suggest.

1 Meier D, Beresford L. Palliative care/intensive care unit interface: Opportunity for mutual education. Journal of Palliative Medicine 2006, 9:1: 17-20.