National Consenus Project 2009 Palliative Care Leadership Award Winners

Center for Comprehensive Palliative Care
Consulting Service
The Center for Comprehensive Palliative Care, based in Ocala, Florida, strives to provide the highest quality holistic care to those who suffer from life-limiting diseases. Patient-centered, family focused care targeting quality of life issues, comfort care and symptom management is provided by an integrated multidisciplinary team with the goal of relieving suffering whether it is physical, spiritual or psychosocial. Members of the team provide these services primarily to hospitalized patients, residents of nursing homes, patients in their own homes, and county jail inmates suffering from chronic and debilitating illnesses. The focus in this program is not only to relieve suffering of the patient, but also to offer compassionate support and mutual understanding between the medical team, nursing staff, patient and families. The continuous education of physicians, hospital staff, facility teams and the general public on the emerging role of palliative care in the healthcare field is also an underlying focus of the program. The Center for Comprehensive Palliative Care has implemented the philosophy and practices demonstrated in the NCP Guidelines and the NQF Preferred Practices.

Community PedsCare
Community Hospice of NE Florida
Serving a five-county area, Community PedsCare is a pediatric palliative care and hospice program for children with life-limiting and life-threatening conditions. The program offers comprehensive in-home services that focus on the immediate and ongoing concerns impacting the child’s comfort and quality of life. This medical, nursing, psychosocial, spiritual, child-life specialist, and volunteer support is provided at the level needed by both the child and the child’s family as each member individually and uniquely deals with the issues associated with caring for and/or sharing life with a special needs child. Support also is provided in the hospital and to parents whose unborn child has been diagnosed with a condition that is not compatible with life outside the womb. Community PedsCare has incorporated the NCP Guidelines into their existing programs of pediatric trained volunteers, bereavement baskets, and involving older children in decision making.

Hope Hospice and Community Services
Hope Hospice
Operating in Fort Myers, Florida, Hope Hospice and Community Services provides a unique continuum of palliative care services, which is unlike any other health care program in the United States. This program, titled Hope Hospice, is a free-standing program based on the philosophy of “unifying and coordinating.” Specifically, the program consists of five specific service lines that are linked together to cover all ages beginning with the Partners in Care Program, Hope Life Care program, Hope Select Care-PACE program, Home Comfort Care, and Hope Hospice. Each program and service line has its own specific staff, trained to deliver palliative care in a particular age group and setting. In 2005, Hope Hospice partnered with Lee Memorial Healthcare Systems to form the Q-Life Palliative Care Consulting Services. This combined effort maintains an overall satisfaction rate above 90% among the 5,000 patients cared for annually. Hope Hospice has integrated the domains of the NCP Guidelines into their program in numerous ways, including a grid demonstrating all NQF preferred practices are being met through all service lines and detailed algorithms for pain and symptom management.

Hospice of the Western Reserve
Palliative Care Program
The Palliative Care Program at Hospice of the Western Reserve was established in 2002 to serve patients in the community who may or may not be ready for hospice care or do not choose to have hospice care and are having pain and symptom management issues. Palliative care is comprehensive care available at any point and in any setting during the disease process and may be used in conjunction with other therapies. Patients, caregivers, and physicians may make referrals to the program. The focus of care is on the physical, emotional, psychological, and spiritual needs of patients and families. The Palliative Care team, which comprises APNs, RNs, social workers, spiritual care, pharmacists, nursing assistants, trained volunteers, as well as therapists for music, art, and massage, works closely with each patient’s physician to create an individualized plan for pain and symptom management. Since its inception, the program has enabled more than 2,500 patients to experience a decrease in their symptom burden, and more than 50% have had a seamless transition to hospice care. Palliative Care Program at Hospice of the Western Reserve has integrated the domains of the NCP Guidelines into their program in many ways including providing student and intern rotations in palliative care, development of a bereavement packet, and presentation of cases at ethics meetings.

Motion Picture & Television Fund
MPTF Palliative Care Services
The Motion Picture & Television Fund delivers health and human services to the Southern California entertainment community. The 45-acre Wasserman Campus in Woodland Hills, CA, is home to 189 retirees living in assisted and residential communities, and an additional 170 seniors living in its nursing home. Its team acts in both consultative fashion as well as direct care practitioners, includes members from medicine, nursing, social services, chaplaincy, dietary and activities, and is led by the Medical Director of Geriatric Services. Their clinics serve approximately 50,000 entertainment industry employees and retirees living in Southern California, with approximately 140,000 clinic visits annually. There are plans to expand the team’s services beyond the Wasserman Campus. Motion Picture & Television Fund Palliative Care Services was founded on the principles of the National Quality Forum Preferred Practices for Hospice and Palliative Care.

Our Lady of Lourdes Memorial Hospital
Palliative Medicine Program
The Our Lady of Lourdes Memorial Hospital, located in Binghamton, NY, provides evidence-based, aggressive management of multiple symptoms that accompany life-threatening illnesses and its treatment. The Lourdes Palliative Medicine Program consists of an interdisciplinary team, including a physician, nurse, social worker, chaplain and a massage therapist. This team of professionals offers free massages to all patients, music therapy through the lending of CD players, and music to families to help them relax. For the fiscal year 2008, the Lourdes Palliative Medicine Program had 313 inpatient consults and 439 follow-up visits to adult patients and 35 outpatient consults with 152 follow-up visits. Our Lady of Lourdes Memorial Hospital has successfully implemented aspects of the NCP Guidelines, including family meetings, chaplain visits within 24 hours, “Gone From My Sight” booklets offered to families of imminently dying patients.

Stony Brook University Medical Center
Survivorship and Supportive Care
The Survivorship and Supportive Care Service (SOS) was launched in January of 2007. It is the first comprehensive palliative care program at Stony Brook University Medical Center. The service is based in the Department of Internal Medicine, Division of Oncology and is directed by a board-certified hospice and palliative care medicine physician. The team is composed of 1 FTE physician, 2 FTE NP, and 0.5 FTE social worker. Ancillary members include a spiritual counselor and a lawyer. The service has seen more than 60 patients and received 40-60 consults each month. Along with an average daily census of 15 patients, the SOS team has followed more than 60 patients at home. The Survivorship and Supportive Care Service has integrated the NCP Guidelines into its program, including assessment templates, opioid order sets, and a “Debrief the Grief” project.

St Rose Dominican Hospitals
Palliative Care Program
The St. Rose Palliative Care Program is a consultative model that serves patients with a newly diagnosed terminal illness through end of life. The program focuses on early identification of patents with terminal illness, which leads to an increased opportunity for advance care planning discussion. Family conversations are held to help identify patient preferences in preparation for subsequent inpatient visits. The palliative care staff discusses advance directives prior to critical hospitalizations, thus reducing the need for decisions to be made in crisis and allowing family members to make better informed crucial decisions. The St. Rose Palliative Care Program has used the eight clinical practice domains of the NCP Guidelines to build interdisciplinary competencies.

VCU Health System/VCU Massey Cancer Center
Thomas Palliative Care Program
The Thomas Palliative Care Program, an acute-care hospital-based program, treats pain and other symptoms for patients with life-limiting illnesses. An interdisciplinary team of physicians and nurses, social workers, physical and occupational therapists, chaplains, clerical staff, and volunteers attend to the patients’ physical comfort, emotional and psychological health, and social and spiritual needs, and provide support for family members and friends. The program includes discrete structural components: an 11-bed dedicated unit specifically for acute palliative care; a consultation service; and a pain and symptom management clinic. The Thomas Palliative Care Program attributes its ability to raise their standard of palliative care to use of the NCP Guidelines.