Meeting Patients Where They Are Rodney Tucker, MD MMM Chief - - PowerPoint PPT Presentation
Meeting Patients Where They Are Rodney Tucker, MD MMM Chief Experience Officer, UAB Medicine Director, UAB Center for Palliative and Supportive Care Disclosures No Financial Disclosures Dr. Tucker is a speaker for the Studer Group in
Chief Experience Officer, UAB Medicine Director, UAB Center for Palliative and Supportive Care
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No Financial Disclosures
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Identify opportunities for promoting upstream
Discuss settings of care that meet patients
Discuss the differences between palliative care
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Palliative care is specialized medical care for people
Relief from the symptoms and honors goals whatever
Improve quality of life for both the patient and the
Appropriate at any age and at any stage of a serious
Extra layer of care
https://www.capc.org/payers/palliative- care-definitions/
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Can be delivered along
Don’t have to sign up for it Can be a long term care
Delivered by a team in
Not just end of life care
Payment mechanism Traditionally delivered at
Have to sign up for it Primarily geared toward
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Doctors Nurse practitioners,
Nurses Social Workers Pastoral Care Music therapists Pet therapy Massage therapists VOLUNTEERS Psychology,
Nutritionist Complementary
Pharmacists
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Physical Psychosocial Emotional Spiritual
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Studies have shown significant impact on several
Palliative care consult services and units have
Leaders in Patient and Family Centered Care model Recognized that early palliative care intervention in
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Many groups of patients with serious illness
Criteria and triggers are simply Guidelines ASK YOURSELF THE SURPRISE
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Would you be surprised if my loved one
Would you be surprised if my loved one
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PC is fastest growing medical specialty in US >150% increase in hospital based programs
Large majority of hospitals over 250 beds have
Diagnosis of patients accessing PC and
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Education re: diff between hospice and PSC Cultural beliefs re: dying (patients and
Provider shortage Difficulty in broadening the evidence base Rural locales Payment mechanisms
Avoidable Suffering Due to Dysfunction in Care System Unavoidable Suffering Due to Treatment Suffering Due to Diagnosis
Tom Lee, MD CMO Press Ganey
Hospital (HCAHPS) Clinics (PQRS CAHPS) ED (ED CAHPS) Surgery (OS CAHPS) Patients Experience
Hospital PCU Consult Svc Clinics Supportive Care ED Triggers
Early Identification
Home In the Community Palliative and Supportive Care Impact
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Consultation Inpatient unit
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Hospital PCU Consult Svc Clinics Supportive Care ED Triggers
Early Identification
Home In the Community Palliative and Supportive Care Impact
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Rapid rapport; “Treat them and street them” Not the best place to have a PC conversation Role for enhanced EMR in order to find
Can be pivotal to an organizations mission and
Requires rapid assessment and coordination
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The Latest Site for Palliative Care: The
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Hospital PCU Consult Svc Clinics Supportive Care ED Triggers
Early Identification
Home In the Community Palliative and Supportive Care Impact
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Clinic-based models Home-based palliative care Community entities – parish nurses,
Nursing homes, assisted living “Telemedicine” models Hospice
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Geographic clinic Embedded clinic e.g. in an oncology practice or
Embedded expertise in primary palliative care
Transitional clinics such as discharge clinics for
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Established members of the
community they serve
“Natural helpers” Recruited by sites: “who in
the community would you expect to have helpful guidance if…”
Retired school teachers,
cancer survivors, persons who had some medical exposure (worked desk at local MD office…)
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EMPOWER patients to take an active role in their
healthcare Identify resources Recognize clinical symptoms Understand disease and treatment Engage in ACP/end-of-life discussions with their providers
Eliminate Barriers
Link patients with resources to get to appointments Connect patients to providers to address symptoms Coordinate care between multiple providers
Ensure Timely Delivery of Care
Help patients navigate the health care system Assist with access to care
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12 cancer centers
across 5 southeastern states
~40 lay (non-clinical)
navigators
Nurse site managers
University of Alabama at Birmingham Health System Cancer Community Network (CCN)
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Model of in-home nurse practitioner level
Patients are referred to service by their PCP or
The “customer” is the Medicare Advantage
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The key to spreading PSC and taking it to the
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Re-evaluate your assessment of loved ones
Consider conversations around advance care
Question and Investigate whether your hospital
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Palliative care is restoring the art of medicine
Palliative care is about matching evidence with
Palliative care is about how we choose to live,
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Questions or for more information: Rodney Tucker, MD MMM