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care education. As we expanded our committee, there were more staff available for continued palliative care education initiatives. For example, we were able to provide lunch and learns
on nursing units to promote CAPC membership and the courses. One member presented at Grand Rounds and at our ACO Provider Quarterly meeting. which departments were not represented at the table, and then members went to educational information on palliative care. An important component to changing
a culture of service delivery is to foster
a sense of inclusivity throughout the departments and system. In addition to our grassroots educational efforts, this expanded membership paved the way for integrating palliative care into the Family Medicine Residency Program.
Most medical residency programs do not have a formal curriculum for palliative care. Integrating palliative care into
a residency program is an effective
way to ensure that more physicians understand palliative care, and can identify appropriate patients, assess and treat for pain and symptom management, advance care planning, and improve communication skills with information such as breaking bad news and leading family meetings.
STEP 5: MEASURE YOUR RESULTS AND SHARE THEM
The adage goes, “if you don’t measure
it, you can’t improve it.” This sage advice can apply to numerous process measures, such as number of staff completing CAPC modules, number
of palliative care referrals, HCAPS scores, and staff surveys on knowledge regarding palliative care and its
impact on the provision of care or pain management.
Our membership in CAPC has allowed us to measure enrollment and course completion, a resource we have and continue to rely on to disseminate palliative care education. We began our journey with two members on CAPC with no course completions.
In just over one year, we now have
125 users within our acute care hospital and residency program, home care,
and LIFE program with 645 course completions.
We also shared our success with the Saint Francis community via our intranet and web links. And we provided access for interested staff to join the educational programs.
SUMMARY AND CONCLUSION
Across the U.S., hospitals are creating palliative care programs. There are
a growing number of authoritative resources available to help facilitate staff education and engagement. Often, the costs associated with hiring experts is challenging for hospitals. Understanding the basic tenets of palliative care and which aspects are most critical to each institution can help focus the effort
and facilitate progress. Educating and empowering front line staff fosters a culture of caring and brings some of
the basic and most important tools of palliative care to our patients and their families. At Saint Francis, we focused on a few key components of palliative care, including pain management, symptom management, and communication
skills. We were able to organically develop these skills in our staff and reach a tipping point in the provision of palliative care to our patients.
CONTRIBUTING AUTHOR
■ ALLISON GONZALEZ, DSW, MSW, LCSW
is a Licensed Clinical Social Worker and the Palliative Care Liaison at Saint Francis Hospital in Wilmington, Del.
REFERENCES
1. Center to Advance Palliative Care (CAPC). About Palliative Care. Available at: https:// www.capc.org/about/palliative-care/.
2. Morrison RS, Dietrich J, Ladwig S, et al. Palliative care consultation teams cut hospital costs for Medicaid beneficiaries. Health Affairs. 2011;30:454-463.
3. West LA, Cole S, Goodkind D, He W. 65+ in the United States: 2010. US Census Bureau. 23-212. 2014. US Government Printing Office, Washington DC. Available at: Census.gov.
4. Beaulieu D. Perfecting palliative care. Health Leaders Media. Feb. 1,2017. Available
at: http://www.healthleadersmedia.com/ physician-leaders/perfecting-palliative-care?s pMailingID=10441408&spUserID=MTY3ODg 4NTUxMTQwS0&spJobID=1101257882&spR eportId=MTEwMTI1Nzg4MgS2.
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