Phoebe Putney Memorial Hospital Description

Phoebe Putney Memorial Hospital is a 443 bedded not for profit, community hospital in Albany, Georgia, serving a large urban and rural community. It has a well established hospice with a full time medical director who was providing a sporadic/part time palliative care and pain consult service both on an inpatient and outpatient basis. However, in July 2006, a full time palliative care physician was employed by the hospital to grow the PC (palliative care) consult service.

The number of palliative care consults (inpatient and outpatient), have been tracked for the first year of having a dedicated full time Palliative Care Physician led consult service, to show the need for additional personnel and showing cost savings to justify budgeting for a palliative care interdisciplinary team.

Goal

To show significant cost savings within one year of having a palliative care consult service with a dedicated full time physician and thereby making the case for budgeting for additional personnel to make up an interdisciplinary team

Measures

• Historical data of actual number of palliative care consults in the first year of having a dedicated palliative care consult service
• Hospital size (total number of beds)
• Average length of hospital stay
• Overall cost per day per patient
• Estimated deaths per year
• Average hospital occupancy
• Total discharges per year

Data Collected

The total number of palliative care consults (inpatient and outpatient) received in the first year of a dedicated palliative care service was collated and shown graphically in comparison with the prior 2 years of a more sporadic/part time service offered by the full time hospice medical director. This data was also used in conjunction with hospital data for that fiscal year, by using the CAPC Impact Calculator, to show estimated cost savings from having this service in place.

• Total number of palliative care consults for fiscal year; 405 (381 inpatient; 24 outpatient)
• Number of beds; 443 licensed (staffed; 329 - based on average hospital occupancy of 74.23%)
• Total discharges per year; 22492
• Average length of stay; 5.18 days
• Overall cost per day per patient; $1,905.00
• Estimated deaths per year; 566
• Average hospital occupancy; 74.23%
• Average length of stay savings per case and average remaining length of stay days after referral to palliative care (Impact days), were estimated as per CAPC Impact Calculator. (CAPC - Center to Advance Palliative Care)

Graphs and Tables of Results:

Summary of Results/What Worked and Why

The historical data showed a nearly 800% increase in the number of palliative care consults within the first year of having a dedicated palliative care consult service, confirming the need for the service.

Using the number of inpatient consults in conjunction with hospital data, which is collected routinely anyway and the CAPC Impact Calculator, we were able to show that the service was already exceeding the estimated expected number of consults for our hospital size in its first year, with associated estimated cost savings of over $800,000.00. This does not include income generated from billing from the palliative care physician.

Lessons Learned

Data is readily available if requested from the appropriate hospital departments and the wheel does not need to be reinvented. The required hospital data for this project is collected for each fiscal year routinely and was made available in a day, once we identified what data we needed.

Track operational data from the very beginning and simple data such as number of consults per month and trends, can go a long way in getting administration "buy in".

The outcome of this project was the addition of a full time advanced practice nurse and half time social worker and chaplain positions being included in our budget for the next fiscal year.

The hope is that with an interdisciplinary team in place, we can provide an improved service and continue to grow the service for which there is an obvious need.