Wagner C, RN, MSN
Paoli Hospital
Paoli, PA

Hospital and Program Description

Paoli Hospital is a non-profit, 170-bed, community hospital in the Philadelphia suburbs.

Problem

The hospital wanted to provide Palliative Care services to its patients, but did not have a Palliative Care physician.

Processes to Resolve Problem

Hospital administration created a position for a Palliative Care Nurse Coordinator, to develop a service for the provision of Palliative Care services for the hospital’s inpatients. A master’s prepared nurse, with critical care background, and Palliative Care training, was hired to develop the program. Before launching the program, a four-month planning period was provided, in which the Palliative Care nurse visited various hospitals’ Palliative Care programs to identify which strategies would work within the culture of Paoli Hospital. Training was attended at a CAPC Leadership Training Center hospital. An additional internship in Pain Management was attended by the Palliative Care Nurse-Coordinator. The Palliative Care coordinator then identified individuals, already within the hospital, and approached them to support the program. A pharmacist with pain management training was identified and utilized. Other various individuals in the social work department were also identified. A Palliative Care Steering committee was formed and processes developed for consultations provided by the Palliative Care Nurse.

Outcomes

Palliative Care consultations began in May 2006. Over 200 consultations were provided in the first 6 months of the program, and the number of consultations continues to grow. A second Palliative Care nurse was hired due to increasing patient volumes. The Palliative Care nurses work closely with the entire healthcare team, and all recommendations are discussed with the patient’s attending physician.

Lessons Learned

In the absence of a

Palliative Care Physician, Palliative Care nurses can provide valuable Palliative Care services when working in collaboration with each patient’s individual physician.