Growing a Hospital-Based Palliative Medicine Program

Topic: Education Strategies

The Northside Hospital System is comprised of three community hospitals. The initial need for Palliative Medicine (PM) services originated to serve the growing oncology population in the year of 2013. It quickly became a service provided to all adult patients with serious illness. In the beginning, PM was thought to be a service for end-of-life care. Through education of staff (i.e. physicians, advanced practice professionals, registered nurses, case management, and therapy services), the PM team has been able to impact patients sooner in the earlier stages of their disease trajectory. Patient education focuses on the effects of serious illness on daily life, and how PM can aid in improving quality of life with symptom management and expert dialogue on goals of care and advanced care planning. Staff education, mostly provided by PM nurse practitioners, is periodically delivered throughout the year to various groups within the hospital system.

Northside Hospital Atlanta has seen a dramatic increase in oncology consults for symptom management with the addition of more staff, now consisting of one physician and three nurse practitioners. Northside Hospital Forsyth, the newer program, has seen an increase in overall PM consults in the last year from 22 new consults in May of 2016 to 56 new consults in May 2017, with the addition of another full-time physician. Since beginning education and increasing members to the PM team, the PM program in the Northside Hospital System has seen an increase in the number of consults with a penetration rate now at 4.5% for both hospitals, in comparison to the national average of 3.8% (National Landscape of Hospital-Based Palliative Care: Findings from the National Palliative Care Registry, 2016). This is based on the total number of beds for both hospitals of over 500. The data collected regarding growth of the Northside Hospital System PM Program, is to demonstrate that education and adding team members can have a positive and lasting impact for the program and the hospital system. The addition of staff at both hospitals has led to more visibility within the hospital and the ability to see consults in a timely manner. The PM team developed the education program with the goal of delivering a consistent and comprehensive framework highlighting the foundations of PM. The education of hospital staff has also led to a shift in hospital culture from PM equating to end-of-life to PM enhancing quality of life. At this time, the PM team relies on hospital staff (i.e. chaplains and social workers) to provide extra support for patients. All staff are encouraged to assist in obtaining a PM consult. As we continue to grow the PM team to a third community hospital, the team's goal is to continue to use the education program to foster a positive approach to quality PM services. The Northside Hospital System's goal is to have a fully established interdisciplinary program at each hospital with the addition of more team members.

Author

Co-authors

  • Nastasia Ardalan, MSN, NP-C, ACHPN

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