partners in palliative care program james lee, md the everett clinic everett, washington velda...

Partners in Palliative Care Program

JAMES LEE, MD

THE EVERETT CLINIC

EVERETT, WASHINGTON

VELDA FILZEN, RN, BSN, CHPN, PARTNERS PROGRAM COORDINATOR

PROVIDENCE HOSPICE AND HOME CARE OF SNOHOMISH COUNTY

What is Palliative Care?

• A philosophy of care– Prevent and relieve suffering– Quality of life – Personal growth

• An organized, highly structured care model– Enhancement to disease-based treatment– Assist with decision making– Rendered along with life prolonging treatment, or as

main focus of care

nationalconsensusproject.org

Question…

“Would you be surprised if this patient died in the next one to two years?”

Current Healthcare State – Crisis Management

• So, where do many patients today turn when they have a health crisis?

• The HOSPITAL

One Solution: Palliative Care Program in Primary Care Office Setting

• Treatment options– Based on patient’s wishes and values

– Face-to-face or electronic communication (EHR)

• Proactively avoiding crisis– Medical and social conditions addressed

– Office visits when appropriate

Program Interventions

Program ReferralAssessmentVolunteerChaplainCare planning

w/MD and patient/family

Case/Symptom Management

Monthly contact by phone or home visit

DocumentationData collection

Satisfactions Surveys for Partners Program

• Patients Very High (4.8/5.0)

• Providers Excellent (5.0/5.0)

2007 – Hospice UtilizationPROVIDENCE HOSPICE N=898 PARTNERS PROGRAM N=63

0102030405060708090

100

National (FY '05) Providence Partners

Ave LOS

Median LOS

5964

86

2622

90

Hospital Admission Rate

• Date Range: 8/4/04 – 10/30/06

1.27

2.9

1.34

3.5

0

0.5

1

1.5

2

2.5

3

3.5

4

60 days prior to death 30 days prior to death

Ad

mit

s/p

t mth

Days Before Death

Partners Program- Hospital Admissions Per Patient Month

Partners (n=156)

None (n= 113)

Our Goals

To empower patients in managing their end of life care

To increasePrimary care office case mgmtPatient/provider satisfactionUse of community resourcesHospice and home health referrals

To decreaseUnnecessary hospitalizations and ER visits

James Lee MD

jlee@everettclinic.com

Velda Filzen RN

velda.filzen@providence.org