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Providence Health and Services leads a unique palliative care program for frail elders which provides comprehensive care while achieving a decline in hospital and ICU admissions and allowing nearly 75% of participants to die at home. Read about Providence Portland's ElderPlace, a PACE program, under Long Term Care.
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Catholic Health Initiatives has a longstanding commitment to improving care at life’s end. Their system wide palliative care initiative is described under Creating System Change
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Providence Health and Services palliative and end-of-life care promising practices are listed below by facility. PH&S is a reunification in of two systems of healthcare, Providence Services and Providence Health Systems, sponsored by the Sisters of Providence and representing ministries in Alaska, Washington, Montana, Oregon, and California. This reunification took place in 2006, and a system-wide assessment of Palliative Care Services and Needs has yet to occur. However, both systems are longtime members of the Coalition, with Providence Health System providing the physical home of the Coalition staff and offices since its inception.
Providence Alaska Medical Center has a Palliative Care Consultation Service which includes physician referral for both inpatient and outpatient services. The Palliative Care Planning Committee, meeting since 2003, is committed to working with other healthcare organizations throughout Alaska to identify gaps in palliative care services and create a comprehensive network of services to address the needs of the aging, the chronically ill, and the dying. Current members in addition to the medical center include Providence Extended Care, Providence Family Practice Residency Program, Hospice of Anchorage, and the Mary Conrad Center. A fellowship program in palliative medicine is planned for 2007. Contact: Ted Hefferen, MD, Edwin.Heffernan@providence.org
St. Joseph’s Care Center, a skilled nursing facility in Spokane, has a trained multidisciplinary team headed by Cathy Mindemann, RN, CHPN, (mindemc@shmc.org) which provides expert assessment and care to meet the physical, emotional, spiritual and social needs of patients and families experiencing severe life-limiting illnesses in a more home-like setting. A comfort care room provides family and patients additional support, and the team has developed a close relationship with Hospice services which allows a resident to remain in their “home” while appropriately receiving those added benefits at end-of-life. In addition, administrator Sally Denton (dentons@shmc.org) is on the state and national POLST committees and is an excellent resource for POLST implementation in LTC facilities.
Sacred Heart Medical Center in Spokane offers two comfort care rooms, two music thanatologists, physician palliative care consultations, and a very active pastoral care team. Regular interdisciplinary rounds in the ICU are a precursor to inpatient and outpatient palliative care services in adult, pediatric and perinatal medicine to be more fully operational in the fall of 2006. Fifteen pediatric staff have participated in either peds ELNEC or IPPC training and over 250 adult nursing staff have had ELNEC training. Contact: Jim Shaw, MD, shawj@shmc.org
Spokane Visiting Nurses Association has had an active interdisciplinary palliative care team for several years which meets monthly for vigorous educational sessions and weekly for care conferences. In addition to their excellent nursing and social work staff, the team benefits greatly from their in-house pharmacist and infusion capabilities. Contact Elizabeth Wilton, RN, (509) 534-4300.
Providence Everett has a very active Hospice program and through education of administration, staff and physicians has been serving an increasing number of patients in the hospital. Patients who become Hospice- eligible while in the hospital, a common time for the need for this transition to be identified, are offered that option and the transfer takes place while still an inpatient. This has been experienced as a significant benefit to patients. A pilot project extending this to an inpatient palliative care service will start in the fall of 2006, utilizing certified H&PM physicians and nurse practitioners. Contact: Joanne Roberts, MD, Joanne.Roberts@providence.org
Providence Portland Medical Center, Providence St. Vincent Medical Center and Providence Milwaukie Hospital have had 79 interdisciplinary staff trained as trainers for the Bayer Conversations at the End of Life program. This program helps staff to communicate competently and sensitively with patients and their families about the issues surrounding end of life. These trainers are now beginning to train other staff on the floors and units of the three hospitals in the Portland service area. Trainings are also being conducted by the Center for Health Care Ethics in cross-care giving at EOL for physicians and other clinicians in the Portland service area. More information about promising practices in palliative care in the Portland service area is available by clicking on: http://phsnet.phsor.org/eol/EOL%20Assessment.pdf Contact: Barbara Jaech, MA., project coordinator for palliative and EOL care, Providence Center for Health Care Ethics, Barbara.Jaech@providence.org
Providence St. Vincent Medical Center hosts the Compassionate Volunteer Vigil Program that ensures that no patient at hospital dies alone. Volunteers are present with hospital patients who are actively dying but have no family or friends to support them during this important passage. To date approximately 25 volunteers have been trained for this service. Plans to implement this program at Providence Portland Medical Center are under way. Contact: Beth Ruml, R.N., LCSW, Beth.Ruml@providence.org
St. Joseph Medical Center in Burbank, CA has formed a Palliative/Supportive C.A.R.E. Team (Choices, Answers, Respect, and Expertise.) The team, which consists of a social work manager, RN clinician, certified hospital chaplain, and palliative care medical director, provided 483 hospital consultations in 2005, focusing on pain management, spiritual and emotional counseling, assistance with completion of Advance Directives, and community resource identification and referral (hospice). Team members trained over 665 nurses and nursing assistants in palliative and end-of-life care, and worked closely with key hospital staff in revising and implementing a physician comfort care order set.
Work also began at St. Joseph’s in late November for a designated Comfort Care Suite on the Transitional Care Unit, which opened in April and accommodates patients and their loved ones at the end of life. Contact: Russell Kiefer, Palliative Care Manager, Russell.Kieffer@providence.org
TrinityCare Hospice in Torrance, CA, operates a Kids Care – Pediatric Palliative Care and Hospice, one of three pediatric palliative care/hospice programs in the state of California. TrinityKids Care operates out of TrinityCare Hospice, Torrance. There is a growing need for pediatric palliative care nationally, but not enough board certified physicians to fill this need.
TrinityCare Hospice has also launched an initiative to create a region wide standard for palliative care. There are three TrinityCare offices in the LA area to date. Contact: Glen Komatsu, MD, Director, Doak Center for Palliative Care, Medical Director, TrinityKids Care Pediatric Palliative Care and Hospice, Glen.Komatsu@providence.org
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Have a successful program to share with others? Contact Elna Stockton at 503-215-7009 or elna.stockton@providence.org