Make the best use of scarce resources by building a healthy, high-functioning team that delivers services efficiently.

Use this toolkit to improve team processes and role clarity and to design a program that matches service level to patient need.

What’s in the Toolkit

To ensure financial sustainability, palliative care programs should risk-stratify patients, match service level to patient need, and incorporate strategies such as telehealth to expand capacity.

Navigating Program Tradeoffs
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Illustration of the quality and cost implications of program design decisions.

Population Stratification Considerations
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Guidance on dosing interventions based on patient risk.

Telehealth Start-Up Guide

Key components of telehealth service delivery, especially in a home-based palliative care program.

CCHP Unveils Telehealth Reimbursement Guide for Providers

Information about The Center for Connected Health Policy's new provider resource on Medicare and Medicaid reimbursement for telehealth and mHealth.

Top Ten Tips Palliative Care Clinicians Should Know About Telepalliative Care

Provides a review of the current evidence for telepalliative care and potential applications and practical tips for using the technology.

Patient Engagement Guide
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Identifying the population in need of palliative care, and working with patients and treating clinicians for effective relationships. Includes suggested phone scripts.

Communicating with Treating Clinicians about the Implications of Frailty
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Identifying patients with frailty who are at high risk for health care utilization and adverse outcomes.

Online Clinical Training Courses For All Clinicians

Online training curriculum for all specialties and disciplines to strengthen their care of patients living with serious illness. Free continuing education credits for all, and physicians receive ABIM MOC points for select courses.

Staffing Models Inventory for Home-Based Palliative Care Programs
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Staffing models used by home-based programs. Center to Advance Palliative Care, 2018.

Health IT Functionality and Reporting Checklist
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List of HIT capabilities needed by palliative care programs for population management and data monitoring.

Establish team protocols that support strong communication, role clarity, and appropriate use of the skill sets of the interdisciplinary team.

Improving Team Performance

Strategic planning for new or veteran programs, and a framework for identification of barriers to team efficiency and team health.

Building and Supporting Effective Palliative Care Teams

Hire and onboard your staff, manage program operations, and ensure a healthy high-functioning team using this toolkit.

Strategies for Maximizing the Health/Wellness of Palliative Care Teams

Monograph on processes that promote team health. Center to Advance Palliative Care, 2014.

Improving Team Effectiveness

Part of the Improving Team Effectiveness series, this session covers building and sustaining a stable, effective interdisciplinary team. Ask questions on topics such as hiring and onboarding, role clarity, team communication, and preventing burnout.

Improving Team Effectiveness: Role Clarity for a Highly Effective Interdisciplinary Team

Webinar presentation.

Quick Tips #4: Role Clarity for a Highly Effective Interdisciplinary Team
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Clarify team roles and responsibilities to ensure positive relationships and productivity. Center to Advance Palliative Care, 2018.

Improving Team Effectiveness: Running Effective Interdisciplinary Team (IDT) Meetings

Webinar presentation.

Quick Tips #5: Running Effective Interdisciplinary Team Patient Care Meetings
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Best practices in efficient, effective IDT meetings. Center to Advance Palliative Care, 2018.

Daily Team Meetings: Triage System

Guidelines for effective team meeting management.

Marketing to Increase Referrals

In this Virtual Office Hour, ask questions about how to promote your program, including advice for engaging stakeholders, understanding referral criteria, and using appropriate messaging for marketing palliative care services.

Leveraging Lean Management to Optimize Patient Access and Performance
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Presented by: Jody K. Reyes, MSBA, BSN, OCN, Jenny Mellot, RN, BSN, CRRN, and Christi Sheffield from University of Virginia Cancer Center on Friday, June 29, 2018. Presenters describe how leaders can engage the interdisciplinary team to redesign the care delivery model by utilizing data and LEAN principles to find creative solutions aimed to increase appointment access and optimize clinic workflow.