CAMBIA PCCE NEWSLETT ER

It is with great pleasure that we begin 2016 by presenting our 2015 An-nual Report. The last 12 months have been a remarkable period of growth for the Center. We have welcomed new faculty, initiated a palli-ative care research fellowship program and recruited new research train-ees, completed a successful new clinical pilot training program, imple-mented palliative care quality metrics, prepared for Joint Commission Advanced Certification in Palliative Care, integrated palliative care con-tent into multiple training curriculums, welcomed new leaders to our Community Advisory Board, nearly doubled our membership, and watched research funding for palliative care at UW grow. For more de-tails, check out our newsletter spotlight to the right and click on the An-nual Report link below for a downloadable copy. A special thank you to everyone who has helped make 2015 a stunning success for the Center. We could not have done it without your support! We begin 2016 with great expectations. Our Annual HMC Palliative Care Conference will again be a two-day event held this year at the Swe-dish Cultural Center on May 9th and 10th. We welcome Betty Ferrell, Professor, City of Hope National Medical Center, as our Keynote Speak-er and the conference will focus on reaching diverse populations. Topics include “Addressing the Spiritual Needs of our Patients and Families,” “Palliative Care for the Homeless,” “Cross Cultural Communication,” and “Supporting Hospice Caregivers.” See our save-the-date announce-ment below and we will be circulating details about registration soon! The Cambia PCCE’s Community Advisory Board (CAB) works to pro-vide feedback to the Center about palliative care issues from the patient, family, and public perspectives and helps to spread the word about palli-ative care to the community. Our CAB welcomes two new co-chairs this year. Ron Peck has worked around the globe for fortune 500 companies as a sales and marketing executive in healthcare and is the co-founder of the Blind Judo Foundation. Priscilla Armstrong is the Director of Work-force Development at Skills, Inc., an aerospace manufacturing and fin-ishing company. Both Ron and Priscilla bring passion and personal ex-perience with palliative care to our board and we look forward to work-ing with them to further the mission of the Cambia PCCE. A special thank you to Amy Hamblin who steps down as Chair of the CAB and who did an amazing job launching and growing our Community Adviso-ry Board. If you or anyone you know would be interested in joining our CAB or finding out more, please contact us at pallcntr@uw.edu. Finally, the UW Palliative Care Training Center completed its first suc-cessful pilot year of training for interdisciplinary palliative care specialists in December. We accepted 24 applicants for this 9-month training program that focused on patient-centered care, narrative communication, effective interdisciplinary practice, and palliative care program building and sustainability. Our second year of training will begin in September 2016 and will offer a graduate certificate in palliative care through the UW Professional and Continuing Education program. This certificate is jointly sponsored by the UW Schools of Nursing and Medicine. Many thanks to the Cambia Health Foundation for making our pilot year possible and to the leadership who developed and implemented the program. Be watching future announce-ments about registration for the upcoming year or email pctc@uw.edu for more information. As always, thank you for your support and interest in the Cambia Palliative Care Center of Excellence. We welcome your feedback and look forward to your participation in the ongoing implementation of our Center and in providing excellent care to all patients with serious illness and their families. J. Randall Curtis, MD, MPH Director, UW Cambia Palliative Care Center

of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine

www.uwpalliativecarecenter.com

A Message from the Director

February 2016

2015 Annual Report

The Cambia PCCE is pleased to announce the release of its 2015 Annual Report. This report highlights the accomplishments of the Center over the past year and celebrates the future of our work in palliative care.

You may view a printable copy of the 2015 Cambia PCCE An-nual Report by clicking on the image below:

Newsletter Spotlight

Notable Members’ Accomplishments

If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com

Cambia PCCE Members Bibliography

*Articles listed are 2015-2016 publications in peer-reviewed journals and book chapters. If you have an arti-cle you would like to have featured, please email pallcntr@uw.edu. Albright DL, Washington K, Parker-Oliver D, Lewis A, Kruse RL, Demiris G. The Social Convoy for Family Caregivers Over the Course of Hospice. J Pain Symptom Manage. 2016 Feb;51(2):213-9. Brown CE, Engelberg RA, Nielsen EL, Curtis JR. Palliative Care for Patients Dying in the ICU with Chronic Lung Disease Compared to Metastatic Cancer. Ann Am Thorac Soc. 2016 Jan 19. [Epub ahead of print] Brown CE, Jecker NS, Curtis JR. Inadequate Palliative Care in Chronic Lung Disease: An Issue of Healthcare Inequality. Ann Am Thorac Soc. 2016 Jan 5. [Epub ahead of print] Chaudhuri S, Oudejans D, Thompson HJ, Demiris G. Real-World Accuracy and Use of a Wearable Fall De-tection Device by Older Adults. J Am Geriatr Soc. 2015 Nov;63(11):2415-6. Chung J, Demiris G, Thompson HJ. Ethical Considerations Regarding the Use of Smart Home Technologies for Older Adults: An Integrative Review. Annu Rev Nurs Res. 2016;34(1):155-81. Cox CE, Curtis JR. Using Technology to Create a More Humanistic Approach to Integrating Palliative Care into the Intensive Care Unit. Am J Respir Crit Care Med. 2016 Feb 1;193(3):242-50. doi: 10.1164/rccm.201508-1628CP. Doorenbos, A. Z., Morris, A. M., Haozous, E. A., Harris, H., & Flum, D. R. (2016). Assessing cultural com-petence among oncology surgeons. Journal of Oncology Practice, 12(1), 61-62. Downey L, Hayduk LA, Curtis JR, Engelberg RA, Measuring Depression-Severity in Critically Ill Patients' Families with the Patient Health Questionnaire (PHQ): Tests for Unidimensionality and Longitudinal Meas-urement Invariance, with Implications for CONSORT. .J Pain Symptom Manage. 2015 Dec 17. [Epub ahead of print] Epstein RM, Back AL. A Piece of My Mind. Responding to Suffering. JAMA. 2015 Dec 22-29;314(24):2623-4. PMID: 26720023 Feemster LC, Curtis JR. "We Understand the Prognosis, but We Live with Our Heads in the Clouds": Under-standing Patient and Family Outcome Expectations and Their Influence on Shared Decision Making. Am J Respir Crit Care Med. 2016 Feb 1;193(3):239-41. Katz, R. S. & Johnson, T.A. (2016) When Professionals Weep: Emotional and Countertransference Respons-es in Palliative and End-of-Life Care, 2nd Edition. New York: Routledge-Taylor & Francis. Lazar A, Demiris G, Thompson HJ. Evaluation of a multifunctional technology system in a memory care unit: Opportunities for innovation in dementia care. Inform Health Soc Care. 2016 Jan 28:1-14. Lee JJ, Long AC, Curtis JR, Engelberg RA. The Influence of Race/Ethnicity and Education on Family Rat-ings of the Quality of Dying in the ICU. Journal of pain and symptom management. 2016;51(1):9-16. Pub-Med PMID: 26384556; PMCID: 4701575. Long AC, Downey L, Engelberg RA, Ford DW, Back AL, Curtis JR. Physicians' and Nurse Practitioners' Level of Pessimism About End-of-Life Care During Training: Does It Change Over Time? Journal of pain and symptom management. 2016. Epub 2016/01/31. PubMed PMID: 26826677. Ramos KJ, Downey L, Nielsen EL, Treece PD, Shannon SE, Curtis JR, Engelberg RA. Using Nurse Ratings of Physician Communication in the ICU to Identify Potential Targets for Interventions to Improve End-of-Life Care. J Palliat Med. 2015 Dec 18. [Epub ahead of print] Responding to Patients Requesting Physician-Assisted Death: Physician Involvement at the Very End of Life. Quill TE, Back AL, Block SD. JAMA. 2016 Jan 19;315(3):245-6. PMID: 26784762 Sharma RK, Cameron KA, Chmiel JS, Von Roenn JH, Szmuilowicz E, Prigerson HG, Penedo FJ. “Racial/Ethnic Differences in Inpatient Palliative Care Consultation for Patients with Advanced Cancer” J Clin On-col. 2015 Nov 10;33(32)3802-8. PMID: 26324373 Wong SP, Vig EK, Taylor JS, Burrows NR, Liu CF, Williams DE, Hebert PL, O’Hare AM. Timing of initia-tion of maintenance dialysis: a qualitative analysis of the electronic medical records of a national cohort of patients from the Department of Veterans Affairs. Journal of the American Medical Association Internal Medicine 2016. PMID: 26809745

Palliative Care Training Center Announces Graduate Training Program

Dr. Wayne McCormick, Chair of the Cambia PCCE Clinical Operations, has been appointed holder of the Wil-

liam E. Colson Endowed Chair in Gerontology.

Dr. Randy Curtis, Director of the Cambia PCCE, and Dr. Sarah Shannon will be presented the Dr. Geraldine

“Polly” Bednash Lectureship Award in March 2016 in Washington DC for his inter-professional accomplish-

ments regarding end-of-life care.

Dr. Ann Long was selected by the American Thoracic Society as the first annual 2015 Ziskind Clinical Re-

search Scholar.

Dr. Ardith Doorenbos, Co-Chair of the Cambia PCCE Education Operations has been selected as the keynote

speaker for the Wayne State University College of Nursing Research Day.

Dr. Kathryn Schlenker was the recipient of one of UWMC’s Fall 2015 UW Medicine Cares Awards.

Dr. Elizabeth Loggers has been awarded a grant by the NIH for her project entitled, “Cancer Parenting Educa-

tion in Palliative Care: Taking Care of the Children.”

Dr. Anthony Back Featured in The Washington Post

Dr. Tony Back, Co-Director of the Cambia PCCE was recently featured in an article in the Washington Post entitled, “The simple way doctors can make their patients feel understood.” Based on an article Dr. Back wrote for The Journal of the American Medical Association (JAMA), the Post article discusses how doctors can make a connection to their patients that helps the patient feel understood. CLICK HERE for a link to the Washington Post article. CLICK HERE for a link to the JAMA article.

UW Medicine Palliative Care Services Utilize MEDCON

UW Medicine Palliative Care Services at University of Washington Medical Center, Harborview Medical Center, Northwest Hospital and Valley Medical Center have contracted with MEDCON to provide 24/7 cov-erage for all palliative care needs. MEDCON is a toll-free consultation and referral service of the UW School of Medicine and its academic medical centers, Harborview Medical Center and UW Medical Center. As a major resource for education, medical discovery and patient care, UW School of Medicine places partic-ular importance on its communication with practicing physicians. The line is open 24 hours a day, seven days a week. A MEDCON consultation coordinator will connect you with the appropriate expert. Call toll free 800.326.5300 or email medcon@uw.edu

Wesley Homes Announces Hospice Director Position

New Hospice is coming to King County! Founded in 1944,Wesley Homes is a mission-driven, not-for-profit

organization, strongly rooted in ministry to older adults. We currently serve residents in retirement communi-

ties in Des Moines and Auburn. To serve people in the greater community, Wesley Homes Community Health

Services was started in 2003 and provides in- home care to Wesley residents and community clients throughout

King and Pierce counties. Wesley Homes At Home is the Medicare/Medicaid- certified home health agency

and Home Care by Wesley offers licensed home care services. Having received the Certificate of Need for hos-

pice in King County in June, 2015, Wesley Homes now embarks on a mission to expand its current continuum

of care to include in-home hospice and palliative care. Our program is being designed to offer superior level of

palliative and hospice care focused on symptom management, support for quality and meaningful life for each

patient and their loved ones, and honoring patient goals. We are excited to offer the opportunity to qualified

and passionate individuals to create the interdisciplinary team and establish an exemplary program. Our plan is

to obtain the hospice license, admit our first patients, and obtain Medicare certification this year.

We are currently recruiting applicants for our interdisciplinary team, starting with Hospice Director, Medical

Director, MSW, and other members of the IDT. For more information, please contact Executive Director

Melinda Moore at 206-870-1127 and visit our website at www.wesleyhomes.org.

Cambia PCCE Seeks Educational Resources Weblinks

The Cambia PCCE keeps an up to date Educational Resources webpage on it’s website for clinicians, educa-

tors, patients and family members. The page is located at:

http://www.uwpalliativecarecenter.com/educational-resources.html

The content is largely from suggestions from our members about resources they find most helpful. Since new

resources are constantly emerging, each year we ask our community to email us with new suggestions. We

would like to encourage our members to visit the page and take advantage of any resources you find as well as

send us weblinks to any new resources that you do not see posted on our page.

Please email any resources and weblinks to us at pallcntr@uw.edu.

Dr. Lu Marchand Awarded Farber Faculty Fellowship

Lucille (Lu) Marchand, MD, BSN, FAAHPM was recently awarded the Stuart J Farber, MD and Annalu Far-ber Endowed Faculty Fellowship in Palliative Care Education for her leadership, clinical care, teaching, re-search and scholarly work in palliative care. Like Dr. Farber, she has dedicated her career to family medicine, palliative care, and integrative and narrative medicine. Her love of narrative medicine is at the core of her dedication in providing compassionate care to patients and families and fostering an interdisciplinary ap-proach to clinical care and teaching. Dr. Stuart Farber was a pioneer in palliative care and established the Univeristy of Washington Medical Cen-ter (UWMC) Palliative Care Program in 2005, and was its first director. Together with his wife Annalu, he created curriculum and videos for palliative care education to medical students and other learners, and more recently created the Cambia Palliative Care Training Center for community interdisciplinary clinicians pre-paring to deliver palliative care in a variety of clinical settings. He was the founder of the UW Medical Cen-ter Palliative Care Service and was the UW Cambia Palliative Care Center of Excellence’s first director of clinical operations. Dr. Farber’s palliative care work is recognized locally, regionally and internationally. Dr. Marchand did her medical training at the University of California in San Francisco in the 1980’s, when the AIDS epidemic was raging. Her background as a nurse and this experience of seeing unrelieved suffering and the lack of appreciation for the patient story in medicine, galvanized her work as a pioneer in palliative care. She did her family medicine training at the University of Connecticut and completed a fellowship in family therapy and qualitative research. She was professor of family medicine and coordinator of the pallia-tive care curriculum at the University of Wisconsin Department of Family Medicine for over twenty years.

On a national level, she has been humanities section editor for the AAHPM Quarterly, and has chaired national humanities interest groups. She is a sought after speaker on communication, narrative medicine, compassionate care and other palliative care topics. In 2013, she was recruited to the University of Washington Department of Family Medi-cine (UWDFM) in part by Dr. Farber and Dr. Tom Norris, Chair, to suc-ceed Dr. Farber as the director of the UW Medical Center’s Palliative Care Service, and to develop the section of palliative care in the UWDFM as its first section chief. Through the fellowship, Dr. Marchand will continue the legacy of Stu and Annalu Farber in providing palliative care education in all areas of medical and interdisciplinary training, and honor the patient and family story through the teaching and practice of effective patient centered com-munication.

Palliative Care Research Fellowship Welcomes Jill Steiner

The Palliative Care Research Fellowship Program welcomes it’s newest research fel-low, Dr. Jill Steiner. Jill Steiner, MD is a fellow in the Division of Cardiology at the University of Washington. Jill proposes to study the use of palliative care services in the adult congenital heart disease population. “Adult congenital heart disease refers to the care of a growing, heterogeneous group of patients whose needs are largely un-known. Our ability to care for these patients is limited not only by anatomy and physi-ology, but also by our lack of understanding of their needs as they cope with challeng-es posed by their disease. By understanding the current state of palliative care services in this population, including barriers to and predictors of use, we will be able to im-prove the availability of services as well as patient outcomes.”

Swedish Palliative Care Symposium March 3 -4, 2016

Palliative Care: Focusing on Quality of Life for People With Serious Illness

March 3-4, 2016

New One-and-a-Half Day Format

Workshops: Thursday Afternoon March 3rd

Swedish Cherry Hill

Choose to attend one of these three hour in-depth, advanced care workshops led by expert inter-professional

faculty :

Advanced Pain Management Strategies: Beyond Opioids

Improving and Maintaining Quality of Life for Seriously Ill Patients and Their Loved Ones

Integrative Medicine: Tools for the Care of Clinicians and the Seriously Ill People They Care For

Full Day Symposium: Friday, March 4

New Location: Bell Harbor International Conference Center

Didactic lectures, case presentations and round-table discussions will provide health care professionals of all

disciplines with the tools needed to provide care that enhances the quality of life for seriously ill people and

their loved ones. Topics include best practices for advanced care planning, palliative care from the surgeon's

perspective, training the healthcare workforce to provide palliative care, why early referral to palliative care

improves quality of life for patients and their loved ones, working with difficult patients who are seriously ill,

rehabilitation strategies for patients who are seriously ill and providing palliative care across the continuum.

This year's keynote speaker is Dr. Diane E. Meier, M.D., Executive Director of the Center to Advance Pallia-

tive Care, a national organization devoted to increasing access to palliative care in the United States. She is the

recipient of a MacArthur Fellowship and many other major awards for her outstanding work in palliative care.

As a national leader in Palliative Medicine, Dr. Meier regularly appears on television and in print. Take ad-

vantage of this opportunity to be educated and inspired by her presentation Palliative Care 20/20: Matching

Care to Patient and Family Needs.There will be plenty of time for questions and discussion with Dr. Meier.

For learning objectives, faculty listing, agenda and complete conference details, please visit the

conference website:

http://www.swedish.org/for-health-professionals/cme/conferences/palliative-care

You may attend a workshop session, the full-day symposium or both. Each activity requires a separate registra-

tion. We have something special planned for you. Please join us!

In July 2013, the Palliative Care Training Center (PCTC) was established at the University of Washington through a three-year grant from the Cambia Health Foundation to develop, pilot test and evaluate an interpro-fessional curriculum for clinicians seeking specialty training in palliative care. In December 2015, MDs, ARNPs, RNs, MSWs and one chaplain from around Washington State completed the 9 month pilot program to strongly positive reviews. As the grant comes to an end, the PCTC will sustain the training program by transitioning it into a Graduate Certificate in Palliative Care. The proposed interprofessional Graduate Certificate in Palliative Care is designed for health care providers from nursing, medicine, social work, spiritual care and other disciplines seeking to deliver high quality, per-son-centered palliative care. This curriculum maximizes several teaching modalities including distance learn-ing, peer and faculty mentoring, and three in-person workshops to support participants in developing their expertise in communication, interprofessional team practice, and program sustainability in their palliative care practice. Jointly offered through the Schools of Nursing (SON) and Medicine (SOM), the proposed Graduate Certifi-cate will begin in Autumn 2016 and continue through Spring 2017. The 15-credit, 3 course graduate certifi-cate will admit students with professional experience in nursing (ARNP, DNP), medicine, social work (MSW), spiritual care and other disciplines (e.g., pharmacy, clinical psychology). Competencies for the pro-gram include:

Integrate narrative and person-centered communication skills, attitudes and knowledge into patient and family communication

Deliver person-centered care across the continuum of palliative care

Deliver team-based palliative care

Enhance team development and communication

Apply principles of change management and organizational development to sustain and advance pallia-tive care within the healthcare setting

Describe methods for implementing and tracking palliative care quality metrics The application deadline is May 1st. For additional information and to be notified when applications open, please email pctc@uw.edu “This program led not only to some of my deepest learning experiences, but also in developing lasting bonds with new peers in the palliative care community at large.” Karen Clay, MSW “This past year has been a learning experience unlike any I have encountered. With a creative and supportive staff we have been coaxed and guided through challenging situations” Jerald Sanders, MD “While I have had similar communication courses in the past, this was by far the best! The rewards it has brought to me have allowed me to reap immediate benefits in my practice and will continue to serve me in the years to come.” Charlie Pietrick, ARNP

Dr. Joan Teno featured on KUOW

Dying patients in hospice and nursing homes aren’t always getting the care they need during the last days of their lives. That’s according to a study co-authored by Dr. Joan Teno, a palliative care specialist and Univer-sity of Washington professor of medicine. Teno and her colleagues analyzed Medicare data for the last two days of life of patients, to see if they received any hospice visit. They found that one in eight dying patients does not get a visit. Black patients were less likely than whites to be visited. “In the last days of life pain and other symptoms are exacerbated,” Teno said. CLICK HERE to hear the full interview.

AACN Endorses Palliative Care Competencies

The American Association of Colleges of Nursing (AACN) is pleased to announce its support for a new set of

competencies and recommendations that will guide the education of future nurses on providing quality end-of-

life care. Titled Palliative CARES – Competencies And Recommendations for Educating undergraduate nurs-

ing Students – the AACN Board of Directors voted to endorse this document at its January 2016 meeting in

Naples, FL.

“From initial diagnosis through the end of life, nurses spend more time with seriously ill patients and their fam-

ilies than any other healthcare provider,” said Betty Ferrell, PhD, RN, FPCN, FAAN, Principal Investigator of

ELNEC. “Educating nurses to provide quality palliative care across the lifespan in various clinical and commu-

nity settings is critical as the population ages and patient acuity grows. As a result, the demand for new nurse

graduates with a proficiency in palliative care is increasing in response to the greater number of people living

with serious illness.”

CLICK HERE to see the full press release.