Implementing Palliative Care across the life span

Saturday, 16 November 2013: 3:55 PM

Leisha Buller, MSN, RN, CMSRN
Palliative Care Services, Texas Health Fort Worth, Fort Worth, TX

Session Title: Implementing Palliative Care Across the Life Span

Brief Description: This session will discuss the endeavor at a large metropolitan hospital to implement palliative care services across the life span beginning inutero.

Full description: Palliative care services at our 735 licensed-bed facility recently received palliative care (PC) certification through TJC. Moving forward, our newly unified services quickly learned that 2 diverse teams, adult and perinatal, must form an unlikely partnership. Our overarching goal for seeking certification is to provide patients with the augmented care PC services offers. We examined percentages of deaths in the adult ICUs with and without PC, determined “likelihood to recommend PC services” through a PC-specific patient satisfaction tool, and developed, implemented, and determined the use of triggers to appropriately identify neonatal PC patients. The aforementioned concepts afforded our program the opportunity for continued growth. The most pervasive measure impacting administrative support lied within integration of PC services in the patients that die in the ICU, which is also the most impactful regarding judicious financial use for our healthcare system. Obstacles encountered included hospital wide staff education and preparation, differentiating between PC and hospice services, and process refining with our prenatal PC patients. Our future plans encompass examining the financial ramifications of cost-avoidance, constructing a process for automated PC involvement in patients admitted under the hypothermia protocol, and we are awaiting IRB approval for a quasi-experimental design study in the ICU.