Two Catholic health care providers were among the seven organizations the American Hospital Association honored this year for expanding the reach of palliative and end-of-life care.
St. John Providence Health System of Warren, Mich., received a Circle of Life Award: Celebrating Innovation in Palliative and End-of-Life Care; and St. Mary's Health Care System of Athens, Ga., accepted a Citation of Honor.
St. John Providence — which is part of Ascension Health — was one of three organizations to receive the premier Circle of Life Award during a July 18 ceremony in San Diego. Since about 2005, the six-hospital system has been focusing on improving access to palliative care services, or services that relieve pain and improve support for people with chronic illness and those at the end of life.
Much of the work at St. John Providence is coordinated by multidisciplinary work groups. They have helped to build awareness of palliative care among staff members through education sessions, conferences and seminars called lunch and learns. They also have used a train-the-trainer model to teach more than 150 staff members to champion palliative care and to spread their knowledge to colleagues. Elizabeth DiStefano, the system's palliative care coordinator, estimates more than 1,500 St. John Providence associates have been educated on palliative care.
The work groups have put processes in place to ensure all patients admitted for inpatient care are screened for palliative care needs. The groups also have refined the assessment tools caregivers use to know when palliative care consults are appropriate during patients' stays in the hospital. The tools establish trigger points for having the right conversations about palliative care at the right times. These trigger points are integrated into St. John Providence's electronic medical record.
The palliative care groups have been encouraging caregivers to include spiritual care in patients' treatment, if patients wish to receive it. The caregivers can use spiritual care assessment tools provided by the work groups. To help ensure spiritual needs continue to be addressed after patients' discharge, the work groups have been linking with Detroit's faith community and educating church leaders and their congregations on how to help patients access palliative care services. For instance, the work group has offered education sessions to churches on how to help people who are in pain.
The teams now are looking at how to increase awareness of palliative care services among home care providers.
DiStefano said the work groups have been trying to bring about culture change so that more people understand the value of palliative care. She said she's seeing the results of their efforts as more and more people — both on staff and off — are showing interest in palliative care. DiStefano attributes the groups' success in large part to the support of St. John Providence's leadership team.
St. Mary's citation
St. Mary's, the other ministry organization honored by AHA, was one of four Citation of Honor recipients. Part of Newtown Square, Pa.-based Catholic Health East, St. Mary's has been intensifying its concentration on palliative care over the past three years. With palliative care a relatively new concept to many staff members in 2009, according to St. Mary's Palliative Care Program Manager Tanya Adcock, the hospital has made palliative care education a priority for staff, offering seminars and online learning on topics like pain management. Initially it focused on nurses, social workers, chaplains and others who work closely with patients needing palliative care. It has since been educating other staff.
St. Mary's also is incorporating palliative care discussions into the rounds that caregivers make when evaluating patient treatment. This, along with the education, is helping to increase the number of appropriate patient referrals for palliative care services, according to Adcock.
Much of the hospital's service area is rural and low-income. According to a resource from the Center to Advance Palliative Care and the National Rural Health Association, people in rural areas can lack access to health care professionals, their area may have limited funding for medical supplies and other resources and patients may be difficult to reach because of geographic distances. All such factors can make it difficult for them to get palliative care services.
When St. Mary's hospice and home care staff talk to rural patients and their families about available palliative care treatments, instruction on how to access care is part of the conversation. A cadre of volunteers also assists by visiting patients and families, allowing caregivers respite, delivering meals and sitting with patients at the end of life.
Karen Joyce, director of St. Mary's home health and hospice programs, said the efforts have resulted in more health care providers and other caregivers being aware of patients' palliative care needs and making an effort to provide the right level of care for their needs, at the right time. Without such intentionality, palliative referrals can be made too late, and patients might not get the full benefit of the service.
Adcock added that across the hospital, "We're seeing an increased awareness (of the need to) go beyond the physical needs of the patients, and that has really enhanced the need to provide holistic patient care, where you view the person as a person and not just as a patient. And, we're seeing more advocacy for the patient instead of losing sight of what we're doing for the patient."
In addition to AHA, sponsors of Circle of Life include CHA, the Archstone Foundation, the California HealthCare Foundation, the National Consensus Project for Quality Palliative Care, the National Hospice and Palliative Care Organization and National Hospice Foundation, the American Academy of Hospice and Palliative Medicine and the National Association of Social Workers.