Field of Dreams: Rapid expansion of PC in a Health System

Topic: Health System Strategies

“Build it and they will come”…  Starting a program in a single hospital within a healthcare system has challenges, but spreading PC (Palliative care) across a diverse healthcare system is another level of challenge on a wide scale level. When quality programs begin having outcomes that gain executive level attention, it becomes evident that there is a price to not growing PC programs. We sought to expand PC services across our ten hospital health system after demonstrating outcomes at one site. Our staffing model includes a standard transdisciplinary team model of physician, nurse practitioner, clinical pharmacist, social worker and chaplain at each site. Within two years, our program grew from 4 hospitals to all ten having programs demonstrating valuable outcomes, sharing best practices, leveraging research projects  and working together through discipline-specific clinical councils. This data will reflect the growth over three fiscal years of having a system wide PC service and describe the model for benchmarking quality measures. Overall, our programs have an average of 32% reduction in daily charges compared with pre-PC daily charges. This represented an average decreases in daily charges in the following categories: 33% in medication charges, 53% in laboratory charges, 28% in room charges. We demonstrated early PC consultation (≤4 days) was associated a 32% decrease in length of stay compared to patients with severe/extreme risk of mortality and severity of illness with palliative care coding. Readmission data will be presented per hospital and represent a range of impacts on 30 day all cause readmission compared to other patients with severe/extreme risk of mortality and severity of illness in the hospitals. Penetration and benchmarking for each hospital will be presented.

Author

  • Kathryn A. Walker, PHARMD
  • Senior Clinical and Scientific Director of Palliative Care, Associate Professor
  • MedStar Health
  • 201 E. University Pkwy, 33rd St Bldg
  • Baltimore, MD 21218
  • (410) 375-3699

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