These efforts likely will result in more transitional care programs integrating hospice and palliative care, Rosenberg says.
“Palliative care is different because we try to look at people’s preferences and find value in determining what is the best care for them,” says Ellen Wild, RN, CHPN, palliative care nurse coordinator for the Mayo Clinic in Rochester, MN.
“I really hope the new payment models and structure under ACA will by necessity include palliative care more,” Rosenberg says.
“So many people are struggling for a long time when they really should have been in hospice or palliative care.” The ACA focuses on improved quality of care, and the health industry is collecting data that shows how expensive end-of-life care is when patients spend their last days in and out of hospitals.
Mary Potter Hospice have taken advantage of the ability to give local GPs access to their own patients on Pal Care (the "primary care initiative" in the following case study).
As told by one of their staff members: "Families are also our patients and they are getting enhanced care because of the primary care initiative.The on-call service has seen major improvements for staff and for patients.Instead of taking two suitcases of paper histories home when on call, the nurse now needs to only take a laptop.They can all share those notes at the one time and have that discussion.”The benefits of Pal Care have been recognised by Hospice Southland’s accreditors.After commencing using Pal Care, they gained their first two “continuous improvement” notations for their documentation.Prior to implementing Pal Care, all patient notes were paper-based.This system was laborious and time consuming, which limited the number of patients that staff could see in a day.Increasing the number of people from a Black, Asian and Minority Ethnic (BAME) background accessing palliative care services – Marie Curie Hospice, Cardiff and the Vale The Conversation Project – Empowering Royal United Hospitals Bath NHS Foundation Trust staff to feel more comfortable having conversations about the wishes of patients approaching the end of their life Building on Board support, education and training and CQUINs to sustain end of life care improvement – Worcestershire Acute Hospitals NHS Trust University Hospital Southampton NHS Foundation Trust: A whole system approach to improving acute End of Life Care Leeds Teaching Hospital Foundation Trust – A systematic approach to delivering person-centred end of life care improvement across a large trust Derby Hospital Foundation Trust – A measurable impact for patients whose recovery is uncertain Bradford Teaching Hospital Foundation Trust – Getting more people approaching their last year of life home from hospital sooner, if that’s their choice Developing communication skills training at Birmingham City University – Teaching large cohorts of nursing students to respond to the communication needs of patients and carers in a realistic way can be challenging.Small group activities using trained actors to simulate patients and their carers is one way forward.This is a vast improvement in terms of OH&S and in terms of the security of patient information.They have found that multidisciplinary care and communication has been enhanced since using Pal Care.