Sixty-three percent of hospitals with more than 50 beds have palliative-care programs in place, up from just 30 percent a decade ago, according to the Center to Advance Palliative Care. In addition to improving patients’ quality of life, palliative care makes sound financial sense: A 2008 study published in the Archives of Internal Medicine found that patients who received palliative-care services cost hospitals between $1,696 and $4,908 less per admission.
Starting in September, the Joint Commission, an organization that sets hospital standards and monitors their performance, will begin offering voluntary certification for hospital inpatient palliative-care programs. This may improve insurance coverage of the programs, the cost of which is currently borne by hospitals to a large extent.
Typically, palliative care at hospitals is provided by a specially trained team, often consisting of a doctor, nurse, social worker and chaplain. Rather than try to shoehorn palliative-care teams into the emergency department, however, the new program aims to educate staff and change systems throughout the emergency department, says Quest. The hospital’s specialized palliative-care teams would be called in for only the toughest cases.
Garrett Chan was working in the emergency department at Stanford Hospital & Clinics in Palo Alto, Calif., one afternoon when an elderly woman was brought in. It was her 91st birthday, and she had blacked out at her birthday party and taken a fall, fracturing her back.
Chan, a nurse who has a supervisory role in the department and has been incorporating palliative-care principles there, could tell that the woman was upset that she was missing her party. “I knew it was having a negative effect on her health,” says Chan. He called the dietary department of the hospital, which decorated a cake with a “Happy Birthday” message.
The cake put a smile on her face, says Chan, at a time when she was dealing with pain and discomfort and facing uncertainty about what had caused her to black out. “It’s some of these small interventions,” says Chan, “that you might not think are significant, but they have a big effect on psychological and emotional well-being.”
This column is produced through a collaboration between The Post and Kaiser Health News. KHN, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health-care-policy organization that is not affiliated with Kaiser Permanente. E-mail: questions@kaiserhealthnews.org .
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