Date: 09/24/2009
Final
Hospital-provided Palliative Care
HOSPICE AND PALLIATIVE CARE
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09:06 AM -- Hospital-provided Palliative Care
Sean Reed, Advance Practice Nurse, Centura Health, introduced himself and provided a handout to the committee (Attachment A). He stated that his presentation would address palliative care and intervention in the hospital setting, compare four different dying trajectories, evaluate recent palliative care hospital outcomes, and describe national social movement strategies to increase hospital-provided palliative care. Mr. Reed spoke to the four different dying trajectories. He stated that in palliative care, the most typical dying trajectory is a slow decline with a periodic crisis.
09:14 AM
The committee discussed issues surrounding how physicians approach conversations with patients about dying. He spoke to themes that are consistent throughout most of these conversation which include discussions about the process of dying, financial stress, the psychological aspect of dying, and spiritual needs. Mr. Reed described the palliative care team and how the team addresses the palliative care interventions appropriate for each patient.
09:22 AM
Mr. Reed stated that the top three referrals to palliative care provided in a hospital are from the intensive care unit, the medical/cardiac unit, and the oncology unit. He spoke to the financial outcomes of providing palliative care within a hospital setting and the average cost savings. He provided statistics on where patients "go" after they leave the palliative care setting. He stated that a majority go into hospice and home health care. He stated that 23 percent die in the hospital within the palliative care setting. Mr. Reed spoke to the End of Life Nursing Education Consortium that provides education for nurses regarding end of life care. He described the new unit at St. Anthony's Hospital that encompasses both a palliative care and hospice unit. He stated that this model is a benefit to the patient because they do not have to be moved to another facility. He explained that many times when patients are moved from palliative care to a hospice facility they may die in transit.
09:38 AM
Mr. Reed described the cultural shift and social movement towards palliative care. Mr. Reed responded to committee questions. He emphasized the need for education and more planning with regard to end of life issues. He also stated it would be beneficial if Medicare benefits included reimbursement for palliative care.