Wednesday, January 14, 2015

Palliative Care Everywhere!

by Cory Ingram, MD

This Wednesday I look forward to a conversation on how palliative care principles and practices are able to be embedded across health systems in to various disciplines and delivery forms. Palliative care principles when applied in various clinical situations improve the quality of care for patients and families and even their longevity and care affordability. For the first time in history our society is experiencing an unprecedented medical and social situation. It is unprecedented that people are living longer, requiring more complex care, and experiencing more burdens of illness and treatment and dying more ill.

The interventions employed in palliative care focus on symptom management, psychological support, ethical decision-making, coordination of care, spiritual support, prognostication, and goals of care conversations. In practice, I wonder if distillation of these principles to three main areas of focus can sustain the positive impact of palliative care. I wonder if delicate conversations, physical symptom management and non-physical symptom management embedded in all areas of our health system will improve the quality of care for seriously ill patients and their families. Are those three areas comprehensive enough? I also wonder if these three areas of focus will be embraced in various specialties like primary care? How would it work? Is it being done? What tools are needed? Are the barriers of skill, time and money able to be overcome and if so how? How do we influence training and attitudes? What is the relationship between primary and specialty palliative care?

Join me @cjingram this Wednesday night at 8pm CST to explore the concept of palliative care everywhere.

T1: What comes to mind when you think of #HPM everywhere?

T2: What tools will advance #HPM everywhere?

T3: What are and how do we overcome barriers to #HPM everywhere?

References

Temel J.S. et al. Early Palliative Care for Patients with Metastatic Non-Small- Cell Lung Cancer. New England Journal of Medicine. 2010; 363:8:733-742.

Bakitas M. et al. Effects of a Palliative Care Intervention on Clinical Outcomes in Patients with Advanced Cancer. JAMA. 2009;302(7):741-749.

Morrison R.S. et al. Cost Savings Associated with US Hospital Palliative Care Consultation Programs. Arch Intern Med. 2008;168(16):1783-1790.

De Roo M.L. et al. Quality Indicators for Palliative Care: Update of a Systematic Review. Journal of Pain and Symptom Management, 2013, in press.

Quill T, Abernethy A. Generalist plus Specialist Palliative Care – Creating a More Sustainable Model. N Engl J Med. 2013;368:1173-1175.

What: #hpm chat on Twitter
When: Wed 1/7/2015 - 9p ET/ 6p PT
Host: Croy Ingram 

If you are new to Tweetchats, you do not need a Twitter account to follow along. Try using the search function on Twitter. If you do have a Twitter account, we recommend using nurph.com, for ease of following.

We will be posting the transcript and analytics here after the chat takes place. Chat Transcript and Chat Analytics courtesy of @Symplur

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