CAPC Palliative Care Program Spotlight

In this episode, we hear from Drs. Robert Friedman and Kate Tindall of Austin Palliative Care in Texas about their journey in establishing a home-based palliative care program. They discuss the challenges of designing their program, and how they used years of strategic research to identify their patient population, understand the unique needs in their city, and ultimately drive referrals. They share insights on balancing growth with delivering high-quality care, and how palliative care can be a model for value-based care – with the potential to improve quality of care and reduce costs.

Music and Memory: Improving Alzheimer's and Dementia Care by Center to Advance Palliative Care

This episode of the Palliative Care Program Spotlight features a phone interview with Chautauqua Hospice & Palliative Care in Lakewood, NY. The conversation includes a discussion on how to find the right palliative care staff as well as a fascinating look at the team's investment into radio and print marketing which is showing real results.

What happens when your palliative care program's budget is cut significantly? How do you evolve and survive when your institution isn't providing the support you need to meet patients in need? This episode of the Palliative Care Program Spotlight tries to tackle these very questions. Our guest is Jeanne Elnadry, MD who serves as Director of Supportive/Palliative Care at Yuma Regional Medical Center. Her role is to develop palliative care programs, systems, and initiatives throughout the institution, and to provide education in palliative care principles and practices. She is developing clinical programs to provide symptom management and supportive care for patients at Yuma Regional greater Yuma community.

Dr. Stephanie Houck heads up the palliative care program at UT Southwestern Medicine. In this episode, she discusses proving her program's value through data and metrics in the face of a potentially changing funding program. Dr. Houck also discusses promoting palliative care and it’s expansion into additional hospital settings, including the emergency department, oncology, intensive care and ambulatory care units.

Dr. Carl Robert Grey is a Geriatric Medicine Specialist and Co-Director of the Palliative Care Program at Wake Forest Baptist Health in North Carolina. At the time of recording, Dr. Grey was only weeks into his position at Wake Forest. In this episode, he discusses the importance of mentorship, embracing new ideas and innovations, and why he believes having a healthy work/life balance is a key ingredient to successful palliative care staff.

In this episode of the program spotlight series, Mary Alfano-Torres, Medical Director for Chapters Health Palliative Care in Florida, discusses how she prepared her staff to handle the enormous growth her program has experienced. With success comes growing pains and the need to balance the business and patient services is never more important.

How to Better Care for Dementia Patients by Center to Advance Palliative Care

In this episode, Dr. Bob Bergamini of Mercy Palliative Care Services in St. Louis steps into the program spotlight to discuss how his program has fought to reduce readmission rates for his institution. This engaging chat is brought to you by the Center to Advance Palliative Care.

Adriane Mackie RN and Jennifer Blechman MD of Partners in Care in Oregon step into the program spotlight to discuss building and growing an outpatient palliative care program. In this episode, Jennifer and Adriane chat about working with referring physicians to create a culture where upstream palliative care is seen as an extension of their care.

The Rev. Kelley Woggon, M.Div., BCC of Norton Healthcare in Louisville, Kentucky steps into the palliative care program spotlight to discuss her palliative care program's push to move into the outpatient setting. In this chat, Kelley breaks down her challenges and successes into branching out which include staff training, communication with referring physicians, and maintaining institutional support. Kelley also describes the process of how her team recently became Joint Commission Certified in palliative care.

Palliative care specialists can often feel spread thin especially if the team is understaffed or overbooked with consults. Dr. Wendy L. Knowlton, a Hospice and Palliative Care Specialist with Providence Sacred Heart Medical Center in Spokane, Washington, understands firsthand what it's like to feel burnt out. In this engaging conversation, Wendy opens up about a time when she felt overwhelmed and exhausted from the difficulties of the job and how that moment changed the way she manages her team today.

Inge DiPasquale, RN steps into the Program Spotlight to discuss how building relationships with referring physicians helped build her program from the ground up in just three years.

Julie Lehn, PharmD, is a Clinical Pharmacy Specialist in Palliative Care at Banner Health in Phoenix, AZ. in this podcast, she discusses how adding a Pharmacist to a palliative care team can save an institution money, increase referrals, and reduce readmissions. Find out how in this engaging chat.

With great success comes even greater challenges. How do you staff appropriately when your consults grow in big numbers? How do you scale your business model to continue to reach the right patients? Our guest on this episode is Teresa Harvey of Transitions Lifecare in Raleigh, NC whose program recently jumped from 300 consults to 800. In this chat, Teresa discusses her bundled payment model, her need for finding and training the right staff, and her desire to expand the program's reach in the community setting. If you have questions about growing, sustaining, and managing a palliative care program, visit www.CAPC.org.

Our latest guest on the Palliative Care Program Spotlight is Doctor Parag Bharadwaj. Parag is Chief of Palliative Care Medicine at Sentara Health in Norfolk, Virginia. In this conversation, Parag discusses his challenges with hiring the right staff and shares some of his recipes for keeping staff engaged for the long term.

Our guest on this episode is Greg Kimura, Director of Palliative Care for Monarch Healthcare in Orange County, California. In this engaging chat, Greg discusses caring for patients through the continuum of care as well as the importance of patient satisfaction and physician training.

In this episode we chat with Abi Katz, Medical Director of Advanced Illness Management at Fidelity Health Care and Premier Health. In this conversation, Abi breaks down the ways her palliative care programs use data to assess their biggest issues such as finding the right consults, staffing properly, and showing their value to institutional leaders. Abi has a lot to teach us about maximizing the return on investment of collecting impactful data.

How do you create a palliative care culture at an institution when there isn't one? How do you take the idea of palliative care and turn that into a real program that meets the needs of its patients? For the answers, we turned to Dr. Alexander Gamble, the Medical Director of Supportive Care at Phelps County Regional Medical Center in Rolla, Missouri. In this chat, Dr. Gamble discusses how he is growing a palliative care team from the ground up. Host Dan Altano and Dr. Gamble also chat about building lasting relationships with referring clinicians and the challenges of branching out into the rural setting. .

Our guest in this episode of the Program Spotlight is Kristin Edwards who oversees the palliative care service line at Bridgeport Hospital, within a multisite hospital system. Responsible for clinical supervision, hospital staff education, as well as metrics and measurement, Kristin has a lot to share about building lasting relationships with referring clinicians. In this episode, Kristin shares successes in attracting the right referrals, breaks down her lessons learned in building an outpatient palliative care business plan, and details how she's scaling up to deliver palliative care to the patients who need it most.

Our guests on this episode are Dr. Ira Byock and Dr. Kevin Murphy of the Institute for Human Caring of Providence St. Joseph Health. In this chat, Ira and Kevin discuss bringing uniformity to all palliative care programs at this 50 hospital health system serving communities across 7 states. The interview, which took place at the 2017 CAPC National Seminar, touches upon several key topics such as making the business case for palliative care, the importance of educating all clinicians in palliative care skills, and creating a health system culture that stays true to its core values.

Lori Yosick, Director for Community Palliative Care at Trinity Health, is one of the country's leading experts in palliative care. In addition to running the program at Trinity, Lori spends her time helping palliative care programs of all sizes extend their inpatient services to the outpatient setting. In this chat, Lori breaks down her top tips for starting, growing, and sustaining an outpatient program. Lori also discusses how her own missteps in starting an outpatient program taught her the valuable lesson of planning ahead before getting started.

Welcome back to the palliative care program spotlight. In this episode, we’re talking about the challenges of growing and sustaining a palliative care program in the community setting. Our guest is Nancy Jackson—Director of Community Development for Home Hospice of Grayson County in Sherman, TX. In our conversation, Nancy discusses the needs assessment process, building a business model, and partnering up with like-minded organizations to help start a palliative care program in the community.

A common issue palliative care programs face is finding the time to collect and leverage data. It’s hard enough to reach the growing needs of patients let alone stepping back and analyzing the metrics that matter to your team or institution at large. On our hunt to find some programs who have made the investment into data, we crossed paths with Christine Swift, an MSN, CHPN, CCRN, and Manager of the Palliative Care Service at Community Regional Medical Center in Fresno, California. In this episode, Christine discusses how data has helped her team reach new heights and plan for the future.

For those of you who have listened back to previous episodes you know that some of the same hot button issues keep emerging in these chats. One of those issues is finding the right payment model for your program especially in the face of potential changes to our health care system. This episode features a two-part conversation with David Ross Russell, MD of ProHealth Physicians in Connecticut. David is a family physician who was trained in the UK and came to the states 29 years ago. He’s been a palliative care doctor as well as a primary care doctor throughout his entire career and is currently running the palliative care program within ProHealth. In part 1, David and host Dan Altano discuss finding the right patients, payment, and getting institutional buy-in to care for a growing need. In part 2, David discusses some of the program’s successes and challenges in expanding into the community and goes further into payment billing and payment. Enjoy!

Our guest in this episiode is Dr. Paul DeSandre, Director of Palliative and Supportive Care at Grady Health Systems in Atlanta, GA. In our conversation, we discuss rebuilding a palliative care team that was failing and we get into the always interesting and always complicated challenge of rebuilding relationships with referring physicians.

How do you sustain a palliative care program in the community setting? “Communication, communication, communication,” says Stacey Sharp, Director of Medicine Services for Community Health Network in Indiana. Stacey says communicating openly and effectively with institutional leaders, referring physicians, potential partners in the community, as well as patients and families has contributed to the program’s enormous success since opening its doors in 2006. In this eleven-year-span, the program has since grown 364 percent. But with growth comes growing pains. In this episode, Stacey discusses her biggest challenges and successes in expanding into the community setting.

This podcast features a conversation with Gregg VandeKieft, MD, MA, Medical Director for Palliative Care at Providence St. Peter Hospital, a Magnet Hospital in Washington. Palliative Care at Providence St. Peter Hospital is doing well. The program has done a great job engaging primary care clinicians to increase referrals, their institution has bought into their model, and they are staffed with a full time group committed to the cause. But with success comes growing pains and new obstacles. A recent study showed that the majority of hospitals offering palliative care services fail to meet national staffing guidelines. The study looked at over 400 palliative care programs and found that only 25 percent have all recommended staff positions filled full-time. In this conversation with Doctor VandeKieft—whose team does meet the national standard—we discuss his philosophy on training and retaining a robust team of fill time staff to meet their growing need. We also discuss the evolution of palliative care in the last fifteen years and a host of other topics.

Often, palliative care specialists have to double as business specialists. In this episode, we share our conversation with Doctor Christopher Lillis of UC Davis Health System. Chris is one of so many in our industry that are part of successful inpatient programs that are now beginning to test the waters of a home-based palliative care model. In this chat, Chris discusses the challenges of defining the reach and scope of a new program, building partnerships with likeminded organizations, and starting small to make a big impact.

Our guest Amy Frieman, MD, of Meridian Medical Group discusses how her team is transitioning into providing palliative care in the community setting.

On this episode, our guest is Sandhya Rao, a physician and the Director of Palliative Care Service at Boston Medical Center. Sandhya was originally recruited by Boston Medical Center as a part time hospitalist and palliative care doctor. She has since made it her mission to help grow their palliative care program. As we’ve learned from previous episodes of this podcast, with growth comes obstacles—and those obstacles make the big successes that much sweeter.

The Palliative Care Program Spotlight Series travels to Atlanta, Georgia to learn about the Emory Palliative Care Center at Emory St. Joseph’s Hospital. In this episode, we sit down with Sherika Newman, DO, who joined the team as Director of Palliative Medicine in 2014. Upon arrival, Sherika’s team had six consults on their charts. At the end of fiscal year 2016, the team saw 914 new consults and 2,200 in total. While this is a remarkable uptick in activity, with growth comes growing pains. Sherika discusses how she was able to work successfully with referring physicians to build a bridge between specialties and find the right consults. She also gives her tips on managing staff wellness and shares how using data helped gain her support and buy-in from her institution.

Our guest today is Debora Gleason, who is currently the clinical manager for all palliative care programs at Optio Health Services within The Denver Hospice. Debra has a lot to teach us about expanding palliative care into the home setting, and is a great advocate for palliative care.

Our palliative care program spotlight series continues with a fascinating chat with John Mulder, MD, FAAHPM, CHMD, the Medical Director of Trillium Institute and Holland Home Palliative Care. Holland Home began its clinical services in 2007 with home based and skilled nursing facility consultations, added hospital consult services in 2008, and outpatient clinics in 2011. Trillium Institute launched in 2014 with the purpose of developing a portfolio of educational resources for local universities, public events, professional schools and health care institutions, and also to implement navigation services for patients and families living with serious illness. Our chat with John covers how these programs have evolved through this growth. John is big on educating the community at large on what palliative care is and he’s a great spokesman for the benefits of palliative care.

The palliative care program spotlight series goes to the stars with a really interesting behind the scenes look at the Motion Picture and Television Fund, operated by UCLA Health. In this episode, we speak with Nurse Practitioner Linda Healy and Chaplain Rabbi Arthur Rosenberg. This is a wonderful program that was set up to help the entertainment community get proper care when facing serious illness. The program comprises geriatricians, nurse practitioners, nurses, licensed clinical social workers, chaplains, dietitians and activity coordinators. Guidance and counseling is also provided for those struggling with complex decision making about medical issues.

We continue the palliative care program spotlight series with a truly educational chat with two members of the Flagstaff Medical Center palliative care team in Flagstaff, Arizona. My guests today are Emmalee Kennedy who is the Medical Director of the Flagstaff Medical Center palliative care team as well as Donna Clark, a palliative care nurse and clinical coordinator who has been with the program since its inception over ten years ago. This is a story of tremendous programmatic growth and what that means in terms of obstacles. Emmalee and Donna walk us through their strategies for enhancing team wellness, getting institutional buy-in, keeping up with a growing list of consults and much more.

The palliative care program spotlight series continues with Rab Razzak, Director of Outpatient Palliative Medicine at Johns Hopkins Hospital. Simply put: Rab Razzak (Twitter: @rabrazzak) is championing the future of palliative care. He’s big on staff education and he’s incredibly driven to spread the word of what palliative care can do for patients facing serious illness. He also has a lot to offer us about staff wellness and he’s done tremendous work bringing palliative care to locations around the world who are behind the curve.

In this episode of the Palliative Care Program Spotlight podcast series, we’ll be learning about a program that has just begun. Our guest is Nurse Practioner Tiffani Mckenna of Elmhurst Hospital—a small community hospital in Elmhurst, Illinois. Tiffani manages the palliative care program at Elmhurst. At the time of this recording, the program had only been running for four months . For anyone out there who has built a palliative care program from the ground up, you know it comes with a lot of obstacles and growing pains, but it also might come with some truly incredible moments when the community and the hospital start to realize how vital it is to offer palliative care to patients. For those hoping to start a program, this episode will take you behind the scenes of how to open and grow a program.

In this episode of the palliative care program spotlight series, we speak with Katie Perkins of Sincera Supportive Care and Symptom Relief—a palliative care program owned and operated by Hospice of Northwest Ohio. Katie is a wonderful example of a dedicated and cutting edge program director. She’s been with Hospice of Northwest Ohio for almost 8 years and is in her second year of her Director of Palliative Care position. This is a story of enormous programmatic growth in terms of staff and reach. Among the many topics we cover in this conversation, Katie offers fellow specialists advice for bringing palliative care into the community setting.

In Episode 2 of our Program Spotlight Series, we feature Senior CommUnity Care (SCC). SCC is a rural PACE program (Program for All-inclusive Care for the Elderly) that serves approximately 250 participants in two counties on the Western Slope of Colorado. Their parent organization is Volunteers of America. SCC allows participants to age in place by providing individualized care from an interdisciplinary perspective that encompasses curative, palliative, and end-of-life services as appropriate. SCC began in 2008, the formalized end-of-life program began in 2011, and the formalized palliative program began in early 2015.

In Episode 1 of our Program Spotlight Series, we feature CHI Health Palliative Care in Omaha, Nebraska. CHI currently provides inpatient consults across 5 hospitals with a projected 1300 consults this year and over 3,700 patient encounters. The program is supported within the clinic structure and works closely with the hospital medicine program. With two physicians, one nurse practioner, 3.5 RNs and administration support, the team works alongside pastoral care and social services to provide care across multiple campuses.

Sue Degnan, a retiring palliative care social worker at Huntington Hospital, reflects on her accomplished 52-year career and discusses how her successor is the right person to fill her shoes.