Bon Secours Richmond Health System of Richmond, Va., earned palliative care accolades from the American Hospital Association at a July 18 ceremony in San Diego. The four-hospital system received AHA's Circle of Life Award for staffing a team that provides comprehensive palliative care services to patients throughout the Bon Secours Richmond system.
Celebrating Bon Secours Richmond Health System's receipt of a Circle of Life Award are, from left, Dr. Seth Roberts, hospice and palliative care physician; Dr. Leanne Yanni, medical director; and Julie MacPherson, practice administrator — all of them with Bon Secours Richmond's palliative medicine program — Tina Picchi, executive director of the Supportive Care Coalition; and Michael Rodgers, CHA senior vice president of advocacy/public policy.
Bon Secours Richmond was one of three organizations that received the Circle of Life Award at AHA's 24th annual leadership summit. The award is for programs and organizations that excel in providing palliative and end-of-life services and that serve as a model for other organizations. CHA is one of the sponsors of the award program.
Established in 2005 as part of Bon Secours Richmond Hospice, Bon Secours Richmond's Palliative Medicine service was restructured in 2010 as a medical practice within the Bon Secours Medical Group, a 600-provider network that operates throughout Bon Secours Virginia's service area. Bon Secours Richmond is part of Bon Secours Virginia.
The 29-member palliative medicine team includes nine physicians, four nurse practitioners, five social workers, four nurses, a chaplain and six administrative staff members. The vast majority of staff are palliative care certified and dedicated solely to palliative medicine. The program uses an interdisciplinary team to build, implement and refine care plans with patients and their loved ones regardless of the patient's care setting. To the extent possible, the same interdisciplinary team works with the patient on an ongoing basis.
The palliative medicine team manages symptoms and provides support for setting goals for patients with serious and chronic progressive illnesses. Team members address physical pain, emotional stress and spiritual concerns and help patients understand their options.
According to information from the 2016 Circle of Life awards booklet and a related AHA press release, because the palliative medicine program is organized as part of a medical group, its members interact with patients along the entire continuum of care, and team members also build relationships with clinicians representing many different disciplines within that medical group. This structure enables the program to follow patients and their families "wherever they receive treatment, including hospitals, nursing homes, primary care practices and their own homes."
Key to the palliative medicine team's frequent contact with patients are 60 nurse navigators employed by the Bon Secours Medical Group and embedded throughout the Bon Secours Richmond system. Two of them are dedicated to palliative care, but all of them are knowledgeable about the palliative medicine program and able to connect patients who could benefit from those services to that team.
Julie MacPherson is practice administrator for the palliative medicine program. She said, "We do not have an automatic consult trigger, but we do strive to get involved as early as possible. We have been successful in this by educating our health system on the need for early palliative intervention, and providing a 'without walls' approach that expands our services into ambulatory settings and at home."
The team works to reduce frequent use of the emergency department and the hospital by caring for patients proactively in the setting of their choice, oftentimes at home.
MacPherson said under this model, "we are able to intervene before the patient enters the hospital, and/or prevent the admission from happening to begin with."
The Circle of Life booklet said that the palliative medicine service has allowed Bon Secours Richmond to reduce costs.
While Bon Secours Richmond's palliative medicine approach is staff-intensive, it is conducive to population health models coming to the fore, according to the Circle of Life materials.
The Bon Secours Richmond palliative medicine team has expanded its reach by educating and training clinicians throughout the Bon Secours Richmond system on advance care planning, including revamping their electronic health record to enhance these efforts. The team also has partnered with two other Richmond-area health care systems — VCU Health System and HCA Virginia Health System — on a pilot program on advance care planning. The "Respecting Choices" program encourages patients to have conversations about their end-of-life care wishes.
Another Catholic facility program honored at the AHA awards ceremony was OSF Supportive Care of Peoria, Ill., which received a citation of honor. The program spreads and standardizes advanced care planning best practices, fosters conversations about end-of-life care and formal documentation of those wishes. It helps ensure the goals of patients and family members are communicated and implemented across care delivery settings, according to information from the Circle of Life awards booklet.
Both honorees' parent companies — Bon Secours Health System of Marriottsville, Md., and OSF Healthcare of Peoria — are members of the Supportive Care Coalition, a national Catholic membership organization that promotes excellence in palliative care.