This presentation highlights the Potomac Valley (PV) Palliative Care Program (winner of the 2009 AMDA/Evercare Quality Improvement Award), which was launched in 2006, and includes a structure, process and outcomes measures. The presentation outlines how to develop a sustainable palliative care program in a long-term care facility through a process of education and team-building, using facility staff.

Short Description

Multiple barriers exist in providing palliative care in the long-term care setting, including organizational barriers, lack of education, and fiscal constraints (CAPC, 2008). In 2005 Potomac Valley Nursing and Wellness Center, a 175 bed long-term care facility, embarked on a mission to create a program for palliative care in order to improve the quality of end-of-life for its residents. The objectives were to build a sustainable program that followed the guidelines established by the National Consensus Project in 2004, using facility resources and staff, within a manageable budget. The development and operation of the program has proceeded from 2005 until the present, and involves several components:

• Education of Staff: (9/2005 to 5/2006) Educational seminars, including the ELNEC course, were provided to facility staff. Key individuals went for more extensive training and certification in palliative care.
• Building the Team: (6/2006 to 9/2006) Department “champions” were organized into a team which began meeting informally to collaborate on developing the process for providing palliative care.
• Developing the Process for Referral, Assessment and Planning of Care: (6/2006 to 9/2006) The team continued to seek education in palliative care. Outside resources including hospice and palliative care providers were consulted to assist with development of tools for the program.
• Launching the Program: The program was formally launched in September of 2006. Team members initiated the process to identify and offer palliative care services to residents, and continued to meet weekly or bi-weekly to evaluate their needs.
• Measuring Outcomes: Data was compiled after two years, and several positive outcomes were identified in the areas of palliative care and hospice utilization, pain management, and family satisfaction Outcomes for the third year will be compiled in September of 2009.
• Evaluating the Program: The process and outcomes for care are evaluated on an ongoing basis. Education in palliative care is provided to staff on an ongoing basis.

Results

Palliative care referrals have remained steady over time, and the service has become an integrated part of the facility care at the organizational level. The program success has led to expanded community outreach efforts including education and partnerships with local hospice and palliative care organizations.