Perfecting Palliative Care
Interventions to improve quality of life for the seriously ill are often provided haphazardly under current frameworks. Here are five keys for transforming palliative care in your hospital system.
This article first appeared in the January/February 2017 issue of HealthLeaders magazine.
Making the case for providing palliative care isn't the challenge.
The specialty helps patients live not just happier, but also longer lives with their disease—while also reducing costs, University of Pittsburgh Medical Center research shows. As a result, palliative care has caught on. As of 2013, 90% of hospitals with 300 or more beds reported having a palliative care program, as did two-thirds of hospitals with at least 50 beds, according to a study published in the Journal of Palliative Medicine in 2016.
However, despite making inroads into health systems nationwide, palliative care programs often have room for improvement. A 2014 report from the Institute of Medicine called for sweeping changes to strengthen both palliative and end-of-life care nationally.
The IOM committee that produced the report titled Dying in America, noted that patients nationwide often encounter barriers to integrated, person-centered, family-oriented, and consistently accessible care near the end of life. These obstacles include disparities between the services patients and families need and the services they can obtain, barriers in access to care, and "inadequate numbers of palliative care specialists and too little palliative care knowledge among other clinicians who care for individuals with serious advanced illness."
Success key No. 1: Define your objective
To achieve the necessary buy-in to make improvements in all of these areas, organizations must begin with a clear message about what palliative care truly means.
The leading misconception about palliative care—among the public and within the healthcare industry—is that it's synonymous with hospice or end-of-life care. Although hospice and end-of-life programs often include palliative care, this service is not just for the dying.
According to the Center to Advance Palliative Care, "Palliative care is specialized medical care for people with serious illnesses. This type of care is focused on providing patients with relief from the symptoms, pain, and stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family. Palliative care is provided by a team of doctors, nurses, and other specialists who work with a patient's other doctors to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided together with curative treatment."