Palliative care programs can make patients feel more in control of their options at the end of life, and can ease suffering and stress during critical illness. So one New Mexico health system is using its expertise to help other providers establish effective programs.
The U.S. healthcare system has made great strides in expanding and embracing palliative care, but there is still work to be done, according to Nancy Guinn, M.D., medical director of Presbyterian Healthcare at Home. It's essential that healthcare organizations invest in palliative care, Guinn told FierceHealthcare during an exclusive interview. “It allows people to make really valid choices and get the support they need at an appropriate time in their illness.”
Presbyterian Healthcare Services, a nonprofit integrated delivery network with eight hospitals across the state, has invested its resources and set a goal to create a safe space for patients and their families as they’re treated for a serious disease.
In addition to reducing unnecessary patient pain and suffering, an effective palliative care program makes patients feel as though their voices are heard and allows providers room to have critical conversations about care, according to Guinn.
“It’s hard for all of us physically to have enough time to focus on important conversations, and palliative care very much offers that time,” she said.
Presbyterian, one of 10 providers that partners with the Center to Advance Palliative Care, offers training to clinical staff who work for other providers to help them understand the ins and outs of effective palliative care
The first consideration, Guinn said, is that palliative care must exist outside of a fee-for-service payment structure, so funding mechanisms must be in place. To provide compassionate, empathetic palliative care, clinicians need time to spend one-on-one with patients, and volume-driven payment models do not reward that type of care.
Through the training, the clinicians are able to identify key stakeholders and evaluate the strengths and weaknesses in their current approaches. For instance, because Presbyterian is an integrated system, its clinicians have support from multiple specialists and hospitalists when they treat patients with complex conditions; primary care practitioners can connect easily with hospital-employed docs to build a game-plan together.
The training also emphasizes the need for teamwork to make palliative care effective, Guinn said. That team may include nontraditional clinical team members, like social workers or chaplains, depending on patient need.
Presbyterian is also leading the charge in New Mexico for greater emphasis on advanced care planning, Guinn said. The system has volunteers help patients fill out advance directives. It also employs a special manager of advanced planning who ensures that information is inputted into the patients’ electronic health records.