Maximizing Palliative Care Program Efficiency
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. Practices participating in the Serious Illness Population (SIP) option under CMMI’s Primary Care First initiative can especially benefit from these tools.
What’s in the Toolkit
Designing for Efficiency
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.
Illustration of the quality and cost implications of program design decisions.
Guidance on dosing interventions based on patient risk.
Key components of telehealth service delivery, especially in a home-based palliative care program.
Information about The Center for Connected Health Policy's new provider resource on Medicare and Medicaid reimbursement for telehealth and mHealth.
Provides a review of the current evidence for telepalliative care and potential applications and practical tips for using the technology.
Identifying the population in need of palliative care, and working with patients and treating clinicians for effective relationships. Includes suggested phone scripts.
Identifying patients with frailty who are at high risk for health care utilization and adverse outcomes.
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 used by home-based programs. Center to Advance Palliative Care, 2018.
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.
Strategic planning for new or veteran programs, and a framework for identification of barriers to team efficiency and team health.
Hire and onboard your staff, manage program operations, and ensure a healthy high-functioning team using this toolkit.
Monograph on processes that promote team health. Center to Advance Palliative Care, 2014.
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.
Clarify team roles and responsibilities to ensure positive relationships and productivity. Center to Advance Palliative Care, 2018.
Best practices in efficient, effective IDT meetings. Center to Advance Palliative Care, 2018.
Guidelines for effective team meeting management.
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.
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.
Advice from successful programs on how to make "cold calls" to patients identified to benefit from your services.
Sample recruiter-patient audio exchange.