Providing Palliative Care to Patients Throughout the State of Indiana from a Centralized Virtual Palliative Care Hub
Access to palliative care clinicians is a limited resource. Expanding the reach of existing palliative care expertise by utilizing virtual care is one strategy to reach areas that lack access. We delivered virtual services through a centralized hub across multiple health settings and tracked outcome...
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| Published in: | Joint Commission journal on quality and patient safety Vol. 48; no. 12; pp. 635 - 641 |
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| Main Authors: | , , , , |
| Format: | Journal Article |
| Language: | English |
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01-12-2022
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| Abstract | Access to palliative care clinicians is a limited resource. Expanding the reach of existing palliative care expertise by utilizing virtual care is one strategy to reach areas that lack access. We delivered virtual services through a centralized hub across multiple health settings and tracked outcomes.
Through a centralized virtual palliative care hub based in an urban academic health center, access to specialty palliative care was offered across homes, critical access hospitals (CAHs), and extended care facilities (ECFs) in the state of Indiana. Webpage-based platforms were used, and hardware included a cart on wheels for rural hospital sites. Data specific to palliative care were monitored for each encounter.
Over one year, 372 patients were seen for virtual palliative care consultations, of whom 275 (73.9%) were seen in the outpatient setting (where the patient was at home or in an ECF) and 97 (26.1%) were inpatient visits performed in CAHs. Visits occurred with patients from almost all counties in Indiana. Advance directives were established for 286 (76.9%) patients seen, and 107 (28.8%) patients were referred to hospice.
Specialty palliative care is a limited resource that has been further constrained by the COVID-19 pandemic. Our experience demonstrates that centralized virtual hub-based palliative care can be leveraged to provide effective, patient-centered, and compassionate care in regions without a specialist and has the potential to improve access to specialty palliative care. |
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| AbstractList | Access to palliative care clinicians is a limited resource. Expanding the reach of existing palliative care expertise by utilizing virtual care is one strategy to reach areas that lack access. We delivered virtual services through a centralized hub across multiple health settings and tracked outcomes.
Through a centralized virtual palliative care hub based in an urban academic health center, access to specialty palliative care was offered across homes, critical access hospitals (CAHs), and extended care facilities (ECFs) in the state of Indiana. Webpage-based platforms were used, and hardware included a cart on wheels for rural hospital sites. Data specific to palliative care were monitored for each encounter.
Over one year, 372 patients were seen for virtual palliative care consultations, of whom 275 (73.9%) were seen in the outpatient setting (where the patient was at home or in an ECF) and 97 (26.1%) were inpatient visits performed in CAHs. Visits occurred with patients from almost all counties in Indiana. Advance directives were established for 286 (76.9%) patients seen, and 107 (28.8%) patients were referred to hospice.
Specialty palliative care is a limited resource that has been further constrained by the COVID-19 pandemic. Our experience demonstrates that centralized virtual hub-based palliative care can be leveraged to provide effective, patient-centered, and compassionate care in regions without a specialist and has the potential to improve access to specialty palliative care. BACKGROUNDAccess to palliative care clinicians is a limited resource. Expanding the reach of existing palliative care expertise by utilizing virtual care is one strategy to reach areas that lack access. We delivered virtual services through a centralized hub across multiple health settings and tracked outcomes. METHODSThrough a centralized virtual palliative care hub based in an urban academic health center, access to specialty palliative care was offered across homes, critical access hospitals (CAHs), and extended care facilities (ECFs) in the state of Indiana. Webpage-based platforms were used, and hardware included a cart on wheels for rural hospital sites. Data specific to palliative care were monitored for each encounter. RESULTSOver one year, 372 patients were seen for virtual palliative care consultations, of whom 275 (73.9%) were seen in the outpatient setting (where the patient was at home or in an ECF) and 97 (26.1%) were inpatient visits performed in CAHs. Visits occurred with patients from almost all counties in Indiana. Advance directives were established for 286 (76.9%) patients seen, and 107 (28.8%) patients were referred to hospice. CONCLUSIONSpecialty palliative care is a limited resource that has been further constrained by the COVID-19 pandemic. Our experience demonstrates that centralized virtual hub-based palliative care can be leveraged to provide effective, patient-centered, and compassionate care in regions without a specialist and has the potential to improve access to specialty palliative care. |
| Author | Patel, Ami V. Kara, Areeba Countryman, Shannon Sinha, Shilpee Shepard, Eric N. |
| Author_xml | – sequence: 1 givenname: Eric N. orcidid: 0000-0003-0114-6223 surname: Shepard fullname: Shepard, Eric N. email: eshepard@iuhealth.org – sequence: 2 givenname: Ami V. surname: Patel fullname: Patel, Ami V. – sequence: 3 givenname: Shannon orcidid: 0000-0001-7031-3393 surname: Countryman fullname: Countryman, Shannon – sequence: 4 givenname: Areeba orcidid: 0000-0001-5107-3857 surname: Kara fullname: Kara, Areeba – sequence: 5 givenname: Shilpee surname: Sinha fullname: Sinha, Shilpee |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36163320$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/s11920-021-01274-4 10.1200/JCO.2020.38.29_suppl.87 10.1007/s10549-017-4556-2 10.1089/pmr.2020.0075 10.1146/annurev-publhealth-032315-021448 10.1089/jpm.2015.0351 10.1200/JCO.2015.62.1615 10.1161/CIRCULATIONAHA.120.048185 |
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| Keywords | Palliative Care virtual goals of care advance directives hospice |
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| SubjectTerms | Advance Directives COVID-19 - therapy goals of care hospice Humans Indiana Palliative Care Pandemics virtual |
| Title | Providing Palliative Care to Patients Throughout the State of Indiana from a Centralized Virtual Palliative Care Hub |
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