Bozeman Deaconess Hospice and Palliative Care Description

Bozeman Deaconess Hospital is an 80 bed community hospital serving a rural community of 60,000. We have had an active inpatient consultation service for 3 years. We average a monthly census of 23 patients a month with consults coming from the ICU, the cancer center and the inpatient medical surgical floor. Over the past year we have increased palliative care consults on the number patients who die in house to 48%. When our program began, we saw only 18% of patients dying in the hospital. We continue to be an example of how palliative care programs can flourish in even the smallest environment. In addition, we have begun to impact our statewide policy about palliative care by advocating for POLST in the state of Montana, and by working actively with the Montana Pain Initiative to improve pain management in our state

Lessons we have learned so far

1. Be everywhere. Make sure you are indispensable. This includes being available, trolling for consults and offering consults when you over hear discussions among physicians. This has worked particularly well with our orthopedists
2. Remind your discharge planners and your med surg nurses frequently of what you can do for them.
3. Once you have made good physician contact, continue to engage that physician.
4. Get involved on a statewide level. You can have an impact

Where we are going

1. With the coming year we plan to develop a bridge program to deal with patients out in the community, especially at assisted living places and nursing homes
2. We will be pursuing the Joint Commission Palliative Care certification

Included in our poster presentation will be the following graphs

1. Percent of hospital deaths seen by palliative care for the past 3 years
2. Avatar Final Stage of Life satisfaction scores and how this compares with the hospital overall
3. physical symptom improvement for palliative care patients
4. Psychosocial /spiritual support of palliative care patients who died in the hospital
5. Growth of palliative care referrals over the 3 years, including number of palliative patients referred to hospice