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