Tuesday, March 29, 2011
- A formal, organized palliative care program led by an interdisciplinary team whose members possess the requisite expertise in palliative care,
- Leadership endorsement and support of the program’s goals for providing care, treatment and services,
- A special focus on patient and family engagement,
- Processes which support the coordination of care and communication among all care settings and providers, and
- The use of evidence-based national guidelines or expert consensus to guide patient care.
I do like the emphasis on the whole hospital program and not just the team. This may set some higher standards than all teams will be able to accomplish, but then I think that makes all of us strive to do better. Or we can be like Lake Wobegon where everyone is above average. I just wonder what percentage of teams will be able to achieve this certification for the hospital as a whole. This cutoff point will be interesting to watch.
When The Joint Commission comes to your hospital, your palliative care team can get excited because now you may be the people that help the hospital achieve more recognition. The suits in the C-Suite might find a new interest in what your program is doing and hopefully (fingers crossed) you might get the resources and staffing to achieve it!
One slight irony is the Advanced Certification for Palliative Care is housed in The Joint Commissions "Disease-Specific Programs." Palliative care is about people, I guess we have to keep on educating.
Tuesday, March 29, 2011 by Christian Sinclair ·
Quick media round-up from this week:
- Hospitals increasingly offer palliative care - Washington Post
- Critical (Re)thinking: How ICU's are getting a much-needed makeover - Wall Street Journal
- Special needs, Special care (Pediatric Palliative Care) - Boston Globe
- Many doctors still focus more on cure than managing pain - NPR
- Hit by the reality of cancer treatment - NYT Well Blog
All of these were making the rounds on Twitter today with lots of clicks and shares from people not in our field which is always nice to see. I am not going to go into detail on any of these articles tonight, but please share them with your team. I particularly liked the WSJ and Boston Globe one. The NYT blog deserves its own blog post to discuss the importance of language.
If any Pallimed Reader wants to write up a guest post on the WSJ, Boston Globe or NYT articles, email me your 250-500 word write up christian@pallimed.org. (Yes we are open to guest posts, more details to come! See your name in lights, or at least the faint glow of some strangers laptop.)
The NPR and WaPo articles were covering the basics. Obviously important but not sure you will gain a lot from reading those. And interestingly those were both written by the same person Michelle Andrews from the Kaiser Health Network. Not sure why they are covering palliative care issues so much, but keep it up if it gets published.
This convergence doesn't quite rival the 2010 St. Patrick's Day journal smorgasbord of palliative care but is still a pretty impressive grouping of media outlets in just a span of a few days.
by Christian Sinclair ·
Sunday, March 27, 2011
Pallimed has finally undergone the design redux I have been wanting to do since 2010. Some of you may have noticed the new look on the Arts and Humanites blog or the Case Conference blog. With the new design rollout I am focusing on the overall blog functionality, so there may be a few broken links and bugs as I work them out over the next week.
If you do find any please feel free to report them to me at christian@pallimed.org.
Here is a listing of the changes made so far across all the Pallimed blogs:
Comments
- Added Disqus plug-in feature for commenting
- Allows for multiple one click sign-in
- Still allows for subscribing to comments from individual posts
- Still allows for anonymous commenting
- Eliminates Word Captcha Spam protection (the quiggly words)
- Allows for nested replies (so you can reply to one comment right after that comment)
- Allows for ‘Likes’ to comments, increasing the validity/importance of your comments
- Added Print Friendly button to the end of each post
- Allows for removing images
- Can select which text to print
- Can save post as a PDF
- Can email post
- Added automatic text cut off for quick summaries from front page to allow for quick scanning of most recent topics
- Added related posts at the end of each post to help you find other articles of interest.
Social
- Added Facebook share and like buttons with counters on each post
- Added Twitter buttons with counters for each post
Mobile
- Enabled Mobile versions of all three websites.
- Links to Apple and Android Palilmed Apps on top right column
General
- Added #HPM Daily - Daily digest of posts on Twitter about Hospice and Palliative Medicine
- Added 'posts by contributors'
- Updated disclaimer and privacy visibility
- Added Popular posts feature highlighting most clicked posts in last 30 days
- Added widget to see traffic in last 30 days (right column in footer
Navigation
- Added clearer navigation to other Pallimed blogs and Palliative Care Grand Rounds
Sunday, March 27, 2011 by Christian Sinclair ·
Hello all, today we have implemented a new commenting plug-in for the main Pallimed blog. Some of you may have already noticed this at the Arts and Humanities blog or the Case Conference blog. The new commenting system is called DISQUS, and if that looks confusing just say it out loud and you'll get it.
by Christian Sinclair ·
Tuesday, March 22, 2011
Vancouver 2011 |
Tuesday, March 22, 2011 by Lyle Fettig ·
by Christian Sinclair ·
One of my favorite bloggers and a great online supporter of palliative medicine is the Arkansas surgeon RL Bates (@rlbates) who writes at "Suture for a Living." This week she posted her Five Wishes for care near the end of her life on her blog. Why? Partially as a response to reading about the recent Annals of Internal Medicine on the effect of surrogate decision making on the surrogate, partially because her husband has difficulty talking about it, and partially because she wants to avoid conflict between any family members over decisions about her care as she discusses in her post.
Please go read her post and offer any comments. This makes for an interesting ethics case...what would you do if a family member presented you with a blog post like this documenting a patients wishes? It may have already happened to one of you.
PS If I have not convinced you to check out her blog yet, she loves to quilt and posts her creations along with her medical musings for any fans of Americana!)
PPS Do you know it i s less than one month to National Health Care Decisions Day on April 16th? Is your organization doing anything for it this year? (Disclaimer: I am helping NHDD organize social media efforts this year)
by Christian Sinclair ·
Sunday, March 20, 2011
Japanese Communication Style: Comparing the Disclosure of a Nuclear Crisis to Disclosure of Cancer Diagnosis/Prognosis
A reporter for the New York Times recently made this statement (see video below):
"I think the Japanese tend to try to maintain a veneer of calm and not breech topics that might be alarming or insulting (emphasis added). For example, until recently, it was the norm for families not to tell a family member who had cancer (about the cancer) just to save suffering on the part of the family member and we see some of that mentality at play in some of the communications we have seen from Japanese officials who have refused to confirm what turns out now to be a very serious situation at the Fukushima Daiichi plant. They were very slow in acknowledging some of the dangers."
Sunday, March 20, 2011 by Lyle Fettig ·
Looking for people in Japan with stories about palliative care around the Tsunami and Earthquake events
We have covered the role of palliative care in emergencies and in post-disaster medical care before here at Pallimed (Hurricane Ike in Houston 2008, Iowa Floods in 2008, Earthquake in Haiti in 2010) . We are looking for any one in Japan or with connections to health care professionals in Japan to help inform the hospice and palliative medicine communities worldwide about some of the issues faced since the earthquake and tsunami struck.
If you have any stories please email christian@pallimed.org and we will arrange for an interview by email or Skype.
Photo courtesy of Boston.com The Big Picture
by Christian Sinclair ·
Tuesday, March 15, 2011
I’m not sure how it got there, but an article from the Milwaukee Journal Sentinel landed in my inbox last week. It described the foundations of a new documentary, Consider the Conversation, by two friends who had recently experienced losses; one of them is also affiliated with a hospice. The video examines contemporary dying in America from both personal and cultural/health systems perspectives. The personal approach is achieved through “person on the street” interviews and interviews with people dying of progressive diseases. There are also interviews with well-know palliative care experts such as Ira Byock and James Cleary and journalist/author Stephen Kiernan.
Tuesday, March 15, 2011 by Thomas Quinn, APRN ·
"Hi, I'm Here to Place a Pleurx and Provide Palliative Care Consultation": The Interventional Radiologist as HPM Physician
I'll admit I was skeptical of this idea when I first read the abstract, but it's growing on me already.
The American Journal of Roentgenology published a retrospective review of all referrals to an academic interventional radiology service to determine how many of the referrals would be appropriate for a hospice and palliative medicine subspecialist. In brief, 81% of referrals were deemed appropriate for either hospice or palliative care with about half of patients having a malignancy, 20% having end stage renal disease, and a smaller percentage having end stage liver disease or heart disease and other diagnoses.
by Lyle Fettig ·
by Christian Sinclair ·
Well if you think you are any good at predicting in medicine, try your luck on College Basketball with the 3rd Annual Pallimed Bracket Challenge. This year we will be giving away prizes, but no worries no entry fees or betting will be going on here just some friendly competition in predicting the future.
by Christian Sinclair ·
Sunday, March 13, 2011
Sunday, March 13, 2011 by Christian Sinclair ·
Hooray for the sworn enemies of Apple acolytes (of which there seem to be a lot of in medicine), a new Android App is here and you must get it for your phone. (Apple fans don't fret! You got your iPhone, iPad app a year ago.)
Pallimed blogs, comments and Twitter feeds are now available in one convenient Pallimed app for FREE. So for the person who asked me in Vancouver when the Android love attention to the other smartphone OS was coming, You got it now! And to Joanna S who asked Saturday night when it was coming, your wish has been answered, because we are responsive like that.
by Christian Sinclair ·
Tuesday, March 8, 2011
Tuesday, March 8, 2011 by Drew Rosielle MD ·
Sunday, March 6, 2011
"Each year more than 3000 men and women die in U.S. prisons."
"It is estimated that 20% of the U.S. prison population will be elderly by 2025."
These are the sobering figures presented at the end of one of the trailers of Prison Terminal, a documentary about the prison hospice in the Iowa State Penitentiary, where inmates care for their own terminally ill. The film, directed and edited by Edgar Barens, spans a 6-month time period, and follows the lives of the patients, inmate volunteers, and staff. Here's one of the trailers (it starts after the first 15 seconds).
PRISON TERMINAL: THE LAST DAYS OF PRIVATE JACK HALL from Edgar Barens on Vimeo.
Prison Terminal is nearing completion, but needs some money to finish the project. Edgar started a fundraising campaign on Kickstarter March 1st, so if you want to see the full length film, consider a donation. By the way, the very cool thing about Kickstarter is that the money doesn't leave your pocket unless the project reaches its fundraising goal in the specified timeframe. So if, you want to be a part of seeing this project through, please do so by clicking here by Friday, April 15th.
This powerful story while being about the experience of dying and caring for the dying in prison, also makes me think of all kinds of important topics for our field and our country, like
- How we will cope with an ever-growing prison population, especially with increased health needs and costs of elderly inmates?
- Compassionate release is not the norm, but even if it becomes more frequent, how will inmates access health care after their release?
- How can we provide compassionate care to those who are dying in the prison system, or support the hospice initiatives that start on the inside?
- How can we help families have increased contact with the dying inmates?
- What are the special psychosocial, emotional, and spiritual needs of dying prisoners and their families?
- What is the best way to train the inmate volunteers, and what kind of bereavement care do they need afterwards?
Or something that I have struggled with in some of my palliative consultations for hospitalized inmates returning to prison...
- How should I change my prescribing practices to fit the correctional facility health care systems? (For example, no PRN doses of pain medications between certain hours at night because of lack of medical staff. Another example, no fentanyl patches allowed, because they could be removed and used by other inmates.)
Inmate Hospice Volunteers: Bertram Berkett, Michael Glover, Michael Williams, Charles Watkins (from www.PrisonTerminal.com) |
The Prison Terminal website has links to many interesting essays, and the National Prison Hospice Association has links on their site to articles which address a few of these questions.
One other interesting note, Edgar Barens has made two other films, the first, Angola Prison Hospice: Opening the Door, many Pallimed readers may be familiar with. The second, A Sentence of Their Own, is a documentary about a family impacted by one member's incarceration.
Usually a documentary is not just a story, it is an attempt to instigate cultural and societal change, something us hospice and palliative care types embrace wholeheartedly. So, in the spirit of providing compassionate, patient-centered care for everyone who suffers from serious illness, please visit the website, comment on this post, like or share the Vimeo videos, donate to get the movie finished (and maybe even get your own copy), and discuss it with your colleagues, family, and friends.
The more we spread the word about Hospice and Palliative Medicine, whether inside the walls of a prison or outside, through whatever platform we choose, whether it be social media, movies, radio, TV, print, or old-fashioned conversation, the more the public understands the value of what we do.
You can find Edgar and more on Prison Terminal at the website, Facebook and Twitter (@prisonterminal) and of course Kickstarter (where you can donate to the project).
(Edited: Updateed the video embed 12/21/2013)
Sunday, March 6, 2011 by Holly Yang, MD ·
Here is a video I made of the pictures sent to me so far from the 2011 Annual Assembly in Vancouver. Thanks to Rick Butin, Holly Yang, Joan Robinson, and Patricia Maani for sending in photos. And if you watch this and say to yourself there are way too many pictures of Christian in it, then you need to send me some of your own! Imagine if you had one of these videos from all the past years you went to the Assembly. I wish I had done this in the past!
You can look at all the pictures sent in and download them from the Facebook Fan Page for Pallimed.
Don't forget to send in your photos to christian@pallimed.org. I'll add them to a new version of the video.
Disclaimer: this video is not an official video of the AAHPM nor the HPNA. If you would like any photos removed from this video or Facebook, please contact me.
[minor edits made Mon Mar 7th for grammar and typo; also high res video replaced previous low res version]
by Christian Sinclair ·
Diane Meier was recently interviewed for the second time (the first being in 2006) by Richard Heffner on his long running PBS show "The Open Mind." To this audience, the interview does not tackle any ground breaking territory, but it is summarizes well hospice and palliative care, the similarities and the differences. To use this as a training tool for some good sound bites which may be helpful when you need to give your elevator pitch on what we do.
by Christian Sinclair ·
Tuesday, March 1, 2011
Here is the slidedeck from the 2011 AAHPM/HPNA Annual Assembly. You can download them, use them, remix them anyway you want. If you are interested in publishing your slides online, feel free to email me (christian@pallimed.org) and I will promote good slidedecks in hospice and palliative care on Pallimed.
Tuesday, March 1, 2011 by Christian Sinclair ·