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Specialty-Aligned Palliative Care: Responding to the Needs of a Tertiary Care Health System
Samantha L Gelfand1, Joshua R Lakin2, Kate R Sciacca3
1Division of Palliative Medicine (S.L.G, J.R.L, K.R.S., N.J., M.J.L., N.M.L., K.G.S., R.E.L., J.A.T.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Psychosocial Oncology and Palliative Care (S.L.G, J.R.L, K.R.S., N.J., M.J.L., N.M.L., R.E.L., J.A.T.), Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Division of Renal Medicine (S.L.G, E.I.M.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School (S.L.G, J.R.L, E.I.M., A.S.D., N.J., M.J.L., K.G.S., R.E.L., J.A.T.), Boston, Massachusetts, USA.
Background:
Expanding specialty palliative care within complex health systems involves consideration of patients' unmet needs, clinicians' perceptions of palliative care, and the availability of palliative care resources. Prior to this quality improvement (QI) project, palliative care services in our health system primarily served oncology patients.
Intervention:
We undertook a prospective strategic planning process that included executive sponsorship and engagement of institutional leaders and clinicians to help define which palliative care services were most needed by the health system.
Measures:
We interviewed and surveyed a broad range of clinicians including physicians, nurse practitioners, and social workers.
Outcomes:
The two most prominent themes that emerged from the stakeholder engagement process were clinicians' wish for specialty-aligned interprofessional palliative care teams and for expansion of nononcology palliative care access.
Conclusion:
Careful needs assessment and stakeholder engagement can result in goal-directed and data-driven expansion of palliative care services within tertiary health care systems.
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