Hospital palliative care programs have been shown to improve physical and psychological symptom management, caregiver well-being, and family satisfaction. Some studies suggest that palliative care programs may reduce hospital and intensive care unit (ICU) costs by clarifying goals of care and assisting patients and families to select treatments that align with their goals . A landmark study showed that early integration of palliative care services actually improved survival for patients with advanced lung cancer .
Best Practices for Physicians
Frontline healthcare professionals and specialist:
Palliative care should be integrated early in the course of a patient’s illness. All healthcare providers should have the knowledge and skills to provide basic, primary palliative care to patients with serious, life-threatening illness. Physicians should contextualize decisions around goals of care, which preserves hope and optimism but reorients treatment toward appropriate aims .
Palliative care centers:
One validated model that has been proven effective in patients with terminal illness includes the following actions: stating the prognosis at the first visit; appointing someone in the physician’s office to ensure that advance directives are discussed; and offering to discuss the patient’s prognosis, coping strategies, and goals of care at each transition .
Community based programs:
Palliative care should be part of a broader continuum of care, thereby avoiding abrupt changes in the medical course . A palliative care screening tool should be completed by someone in the nursing home environment such as the MDS Coordinator or Admissions Nurse. Ideally, it would serve to identify appropriate patients and would include screening for those with metastatic cancer, advanced cardiac, pulmonary, renal disease and dementia, as well as those with acute symptom needs. Also, recognizing patients without completed advance directives and those with multiple recent hospitalizations could help identify those in greatest need for palliative care .
The interdisciplinary team identifies, communicates, and manages the signs and symptoms of patients at end of life to meet the physical, psychosocial, spiritual, social, and cultural needs of patients and their families . The option of hospice should be discussed as soon as appropriate to avoid late referrals to hospice that can increase patient and family suffering.
Find out more information on best practices.
Continuing Education for Providers
Below are continuing education palliative care resources for providers. Please note some resources may have a cost associated with accessing content.