UCSF Medical Center palliative care experts mentor health care organizations in end-of-life care

03/31/04

UCSF has been named one of six leadership centers in the country for training health care professionals who want to start palliative care programs. These programs deliver high quality care to patients with chronic and terminal illness and their families.

Beginning this week, UCSF Medical Center palliative care experts will host health care professionals from California, Nevada, Arizona and Michigan. Additional trainings are scheduled for June, September and November, 2004.

"While interest in end-of-life care is growing, only 18 percent of hospitals in California offer these services to patients," said Steven Pantilat, MD, associate professor of medicine and director of the palliative care service at UCSF Medical Center. "Our leadership center offers hospitals the expertise, technical assistance and skills necessary to jump start these programs."

Visiting healthcare teams will get information on everything from financial and operational dimensions of establishing a palliative care program to hospice-hospital collaborations. The leadership centers are supported by a nationwide initiative -- The Center to Advance Palliative Care -- and funded by a $4.5 million grant from the Robert Wood Johnson Foundation.

In addition to UCSF Medical Center, the other centers are located at Fairview Health Services, Minneapolis, MN; Massey Cancer Center of Virginia Commonwealth University Medical Center, Richmond, VA; Medical College of Wisconsin, Milwaukee, WI; Mount Carmel Health System, Columbus, OH; and Palliative Care Center of the Bluegrass, Lexington, KY.

The UCSF Medical Center Palliative Care Service focuses on helping patients achieve the best possible quality of life, said Pantilat. The service includes physicians, nurses, chaplains, social workers and pharmacists who work together to address many of the issues that arise for patients facing the end of life and their families, he said.

The program for adults, launched in 1999, has cared for over 1,000 patients. In addition to providing expert advice to physicians and their patients, palliative care experts operate a two-bed unit called the Comfort Care Suites. Designed to be more like home, the suites are quiet and private and feature wood furniture, music, art and warm lighting. Families (including children) are encouraged to stay with their loved ones.

The pediatric program integrates palliative care throughout UCSF Children's Hospital. A core group of specialists ensure that the same caregivers who are working toward cure also help families and children cope with questions of quality of life and with the child's potential death when a life-threatening condition is not responsive to treatment.

"We find that each unit tailors its approach to palliative care to match its patient population's unique circumstances. The care reflects whether the patient is an infant, an older child or even a woman pregnant with an unborn child," said Robin Kramer, RN, MS, PNP, coordinator of the UCSF pediatric palliative care program. "Likewise, care reflects the acuity of the underlying condition -- whether the child is deteriorating rapidly in the intensive care unit, dying shortly after birth from a pre-existing condition not compatible with life, or living for months to years, in and out of the hospital before dying."

The UCSF Children's Hospital comfort care room has been almost in continuous use since it was opened in 2001. Thanks to a grant from the Gap Foundation, the hospital now is adding an additional comfort care room on the pediatric floor and two comfort care rooms near the neonatal intensive care nursery.

Palliative care is offered at any stage of illness, simultaneous with all other appropriate medical treatment, and has been shown to improve quality of care, improve patient satisfaction and save money, said Pantilat.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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