Not enough patients are able to access palliative care at the end of their lives because there aren't enough providers offering it to meet their needs.
So, the National Coalition for Hospice and Palliative Care is releasing a new set of clinical guidelines (PDF) for providers offering care to seriously ill patients in any setting—including primary care offices, hospitals, specialty practices, behavioral health and long-term nursing care facilties—to expand its use.
“There's really a growing body of literature that is demonstrating that the earlier in the course of disease that palliative care can be implemented the more patients can benefit,” Betty Ferrell, Ph.D., co-chair of the project’s steering committee and director of City of Hope’s Division of Nursing Research and Education told FierceHealthcare.
Palliative care focuses on easing the symptoms and stresses that patients with serious illnesses can face. Because it’s a multidisciplinary, specialized type of care, it requires participation from a mix of different providers, Ferrell said.
The guidelines focus in eight domains that cover a range of facets to palliative care, including ethical and legal concerns, cultural differences, psychological needs and end-of-life care.
The end-of-life domain, for example, was updated to reflect the need to have conversations about palliative care sooner following a serious illness diagnosis, and also now highlights the need to provide support to family members and caregivers.
In addition, palliative care’s value in pediatrics is a focus throughout the report. Ferrell said these providers are leading the charge to expand such care, and evidence of its value to patients beyond those at the end of life is evident in neonatal intensive care units.
“So many infants need this type of care,” she said.
Advanced practice clinicians can play a key role in sustaining palliative care’s expansion, as there are too few providers offering such services to meet demand. Physician assistants were “very eager” to take on this type of care through the discussions on updating the guidelines, Ferrell said.
PAs can play a key role particularly in boosting access in rural or underserved areas, where there is an unmet need and demand for palliative care. There needs to be training opportunities for these clinical team members to take on these roles.
All told, 16 national palliative care organizations participated in updating the guidelines, and more than 80 national healthcare groups from across the continuum have signed off on their benefits.
Amy Melnick, executive director of the coalition, told FierceHealthcare that this support is emblematic of the coalition’s members realizing that to truly boost access it was key to bring a wealth of stakeholders into the conversation.
“Our small but mighty coalition can’t do all of the implementation activities alone,” she said.