Michael Harris Chancellor, Indiana University Kokomo, Indiana University Kokomo Chancellor
Indiana University Health University Hospital Palliative Care Services
1
University Hospital Palliative Care Services has educational presentations for groups within the hospital, including the Lunch n’ Learn series, Nursing Grand Rounds, Anesthesia Grand Rounds, Transplant Research Meeting, and other departments within the hospital. Cathy Simpson is involved in Encompass and works with new hires and communication routinely. Nursing students, medical students, emergency medicine residents, and palliative care fellows have all had rotations with the service at University Hospital. Indiana University Health University Hospital Palliative Care Services ABSTRACT OUR TEAM In the past three years the IU Health University Hospital Palliative Care Services has expanded both in staffing and in scope. Our service has gone from one part-time to full- time physician. We have a new palliative care nurse practitioner, our social worker has expanded to four days per week while being involved in staff education, and we have added a clinical coordinator registered nurse. We have expanded our services within “traditional” areas of palliative care such as oncology and hematological malignancies. We see new patient populations with suffering including cystic fibrosis, advanced lung disease, and pre- as well as post-transplant patients including liver, pancreas, kidney, and multivisceral. We are increasingly involved in education both didactics and bedside with medical students, residents, and fellows rotating with our service. In the past year our service has expanded to out- patient by following-up in-patients and embedding within existing clinics. OUR PARADIGM OUT-PATIENT SERVICES DEMOGRAPHICS SUMMARY ALUMNI MEMBERS CONCLUSIONS Marcia Mulcahey Nurse Practitioner Marci relocated to Arizona to be closer to family. She is still working in palliative care. Wendy Siemion Physician Wendy is now a palliative care physician for the Veterans’ Health Administration Indianapolis. All patients deserve palliative care and many can be well served by high-quality primary palliative care. However, some patients whether it is due to specific issues or complexity require a specialized, interdisciplinary team to optimize quality of life. Indiana University Health Palliative Care Services remains committed to optimizing quality of life regardless of prognosis. In order for palliative care programs to grow they must stop identifying themselves with death but rather with the diagnosis and treatment of suffering. Palliative care and hospice as been associated with dying rather than our true mission of helping patients and their families live well in the face of progressive, chronic, or terminal disease. Palliative care is in many ways a new model of care based on a practice as old as Hippocrates: “Cure sometimes, treat often, comfort always.” The Victoria Classification of Palliative Care divides palliative care into three phases: Blue during which active curative treatment occurs, green during which focus is shifted away from cure and toward comfort, and yellow which focuses on active dying and end-of-life care. Here at University Hospital, we continue to see patients that require help with the transition to a comfort approach or are actively dying. In addition, as Palliative Care Services have matured, we have seen patients with increasing life expectancy and are still pursuing active treatment. As our patients’ life expectancies have increased we have had to expand the way we deliver and practice to improve quality of life. Simply managing physical pain is inadequate in a patient that may have much more time to enjoy their quality of life. These patients have more complex management issues leading us to not only evolve our paradigm of care but has also necessitated out- patient follow-up that has subsequently expanded into out-patient referrals. NEW OPPORTUNITIES Mike Aref Lead Physician “I became a palliative care physician by accident, I have always weighed the balance between the burden of suffering and what the patient got out of experiencing that burden.” Cathy Simpson Social Worker “I was eager to become involve in the implementation of a palliative care program because it offers a unique opportunity for social workers to impact the challenges that each patient and family face with a life changing illness. The ability to work to enhance the quality of care through the continuum of an illness has become my passion.” Tim Staker Chaplain “Soon after I became a chaplain I learned that--even with all our technology--hospitals do not have a cure for every illness. Bringing spiritual and emotional comfort to patients with pain and unmanaged symptoms was exactly where I wanted to be. To be part of an interdisciplinary team focused on this kind of care is the most meaningful work I’ve ever done.” Jim Luce Administrative Lead “It really is my life’s work. From an administrative perspective, if I can get a place as big as IU to pay attention and change the way it does things, it will affect not just the suffering in our own hospital, but around the whole state. Not a bad mission.” Emily Malecki Nurse Practitioner “To me, in order to make informed decisions, a patient must have well managed symptoms and understand all of their options. Palliative care allows me to assess and manage the whole patient.” Barb Nation Clinical Coordinator “I worked as a hospice nurse for many years, and I got to see how much our patients and families benefited from inter-disciplinary supportive care. Palliative care expands that belief--that all patients with a life-limiting illness will likely do better when they have symptom management and support. Caring is just as important as curing. ” Michael Aref, MD, PhD, FACP, FHM, Cathy Simpson MSW, LCSW, Emily Malecki, RN, ACNP-BC, Barb Nation, RN, CHPN, and Tim Staker, MDiv, BCC Indiana University School of Medicine and Indiana University Health, Indianapolis, Indiana Pulmonology DaLD SOPA Multidisciplina ry Oncology Hematology Primary Care 617-5787 Outside Palliative Care Consult Currently embedding in referring clinics In the future referrals and follow- ups will come to a dedicated clinic EDUCATION Psychological Review. 1943 50, 370-396. Curr Opin Support Palliat Care. 2008; 2(2):110-3
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Transcript of Indiana University Health University Hospital Palliative Care Services
University Hospital Palliative Care Services has educational presentations for groups within the hospital, including the Lunch n’ Learn series, Nursing Grand Rounds, Anesthesia Grand Rounds, Transplant Research Meeting, and other departments within the hospital. Cathy Simpson is involved in Encompass and works with new hires and communication routinely.Nursing students, medical students, emergency medicine residents, and palliative care fellows have all had rotations with the service at University Hospital.
Indiana University Health University Hospital Palliative Care Services
ABSTRACT
OUR TEAM
In the past three years the IU Health University Hospital Palliative Care Services has expanded both in staffing and in scope.Our service has gone from one part-time to full-time physician. We have a new palliative care nurse practitioner, our social worker has expanded to four days per week while being involved in staff education, and we have added a clinical coordinator registered nurse.We have expanded our services within “traditional” areas of palliative care such as oncology and hematological malignancies. We see new patient populations with suffering including cystic fibrosis, advanced lung disease, and pre- as well as post-transplant patients including liver, pancreas, kidney, and multivisceral.We are increasingly involved in education both didactics and bedside with medical students, residents, and fellows rotating with our service.In the past year our service has expanded to out-patient by following-up in-patients and embedding within existing clinics.
OUR PARADIGM OUT-PATIENT SERVICES
DEMOGRAPHICS
SUMMARY
ALUMNI MEMBERS
CONCLUSIONS
Marcia MulcaheyNurse PractitionerMarci relocated to Arizona to be closer to family. She is still working in palliative care.
Wendy SiemionPhysicianWendy is now a palliative care physician for the Veterans’ Health Administration Indianapolis.
All patients deserve palliative care and many can be well served by high-quality primary palliative care. However, some patients whether it is due to specific issues or complexity require a specialized, interdisciplinary team to optimize quality of life. Indiana University Health Palliative Care Services remains committed to optimizing quality of life regardless of prognosis.In order for palliative care programs to grow they must stop identifying themselves with death but rather with the diagnosis and treatment of suffering. Palliative care and hospice as been associated with dying rather than our true mission of helping patients and their families live well in the face of progressive, chronic, or terminal disease.
Palliative care is in many ways a new model of care based on a practice as old as Hippocrates: “Cure sometimes, treat often, comfort always.”The Victoria Classification of Palliative Care divides palliative care into three phases: Blue during which active curative treatment occurs, green during which focus is shifted away from cure and toward comfort, and yellow which focuses on active dying and end-of-life care. Here at University Hospital, we continue to see patients that require help with the transition to a comfort approach or are actively dying. In addition, as Palliative Care Services have matured, we have seen patients with increasing life expectancy and are still pursuing active treatment.As our patients’ life expectancies have increased we have had to expand the way we deliver and practice to improve quality of life. Simply managing physical pain is inadequate in a patient that may have much more time to enjoy their quality of life. These patients have more complex management issues leading us to not only evolve our paradigm of care but has also necessitated out-patient follow-up that has subsequently expanded into out-patient referrals.
NEW OPPORTUNITIES
Mike ArefLead Physician“I became a palliative care physician by accident, I have always weighed the balance between the burden of suffering and what the patient got out of experiencing that burden.”
Cathy SimpsonSocial Worker“I was eager to become involve in the implementation of a palliative care program because it offers a unique opportunity for social workers to impact the challenges that each patient and family face with a life changing illness. The ability to work to enhance the quality of care through the continuum of an illness has become my passion.”Tim StakerChaplain“Soon after I became a chaplain I learned that--even with all our technology--hospitals do not have a cure for every illness. Bringing spiritual and emotional comfort to patients with pain and unmanaged symptoms was exactly where I wanted to be. To be part of an interdisciplinary team focused on this kind of care is the most meaningful work I’ve ever done.”
Jim LuceAdministrative Lead“It really is my life’s work. From an administrative perspective, if I can get a place as big as IU to pay attention and change the way it does things, it will affect not just the suffering in our own hospital, but around the whole state. Not a bad mission.”
Emily MaleckiNurse Practitioner“To me, in order to make informed decisions, a patient must have well managed symptoms and understand all of their options. Palliative care allows me to assess and manage the whole patient.”Barb NationClinical Coordinator“I worked as a hospice nurse for many years, and I got to see how much our patients and families benefited from inter-disciplinary supportive care. Palliative care expands that belief--that all patients with a life-limiting illness will likely do better when they have symptom management and support. Caring is just as important as curing. ”
Michael Aref, MD, PhD, FACP, FHM, Cathy Simpson MSW, LCSW, Emily Malecki, RN, ACNP-BC, Barb Nation, RN, CHPN, and Tim Staker, MDiv, BCC
Indiana University School of Medicine and Indiana University Health, Indianapolis, Indiana
Pulmonology
DaLD
SOPA
MultidisciplinaryOncology
Hematology Primary Care
617-5787Outside Palliative Care Consult
Currently embedding in referring clinics
In the future referrals and follow-ups will come to a
dedicated clinic
EDUCATION
Psychological Review. 1943 50, 370-396.Curr Opin Support Palliat Care. 2008; 2(2):110-3
