Palliative care—providing relief to patients suffering from serious illness—is a critical piece to relevancy and success in today’s healthcare landscape.
It builds a hospital's reputation, ensures patients aren't saddled with bills for unnecessary treatment, and leads to a better quality of life and clinical outcomes. Recent studies have also shown that patients facing serious illness increasingly want the types of services that palliative care provides—and they expect today’s hospitals to deliver.
Palliative Care by the Numbers
Respondents to a New England Journal of Medicine (NEJM) poll indicate that dedicated palliative/end-of-life care improves patient experience (97 percent), quality of care (94 percent), clinician work satisfaction (88 percent), and cost of care (79 percent).
A report from the American Hospital Association (AHA) revealed that 92 percent of patients say they would be highly likely to consider palliative care for themselves or their families if they had a serious illness.
Yet, 60 percent of patients who would benefit from palliative care are not receiving it, even though most healthcare organizations have end-of-life programs, according to the NEJM Insights Council.
To what do those numbers translate? The need for hospitals, healthcare systems, and physicians to be singularly focused on improving access to these critical services for the patients who need them.
The Disconnect Between Doctors and Palliative Care
Patients and their families increasingly want to talk about end-of-life treatment options with their physicians well before facing a terminal illness. In fact, a poll by Kaiser Health found that 89 percent of patients think doctors should discuss palliative care options with their patients. It’s well known that these types of discussions are essential to extending compassionate care and providing a positive patient experience. The consequences of not having compassionate and comprehensive care conversations can be detrimental to patients and providers alike.
Even though doctors know the acute importance and significant impact of talking with their patients about this topic, many still find palliative care conversations difficult to start—and when they do, they are not sure what to say.
"Poor management of palliative care conversations quickly leads to overwhelming stress, distrust of the medical system, lack of patient and family loyalty, unwanted expenditures, and more," says Dr. Rachel George, Executive Vice President and Chief Medical Officer, SCP Health. "Well-managed palliative care, on the other hand, can have an extremely beneficial impact. It’s a highly important topic to focus on in order to provide high quality, compassionate care for your patients.”
Removing that disconnect means medical schools and hospitals must make palliative care training for doctors a priority and ensure they are immersed in a culture that emphasizes learning and growth in this area, she emphasized.
Roadblocks to Building a Palliative Care Program
The palliative care field faces significant challenges, most notably a shortage of skilled, trained, and boarded palliative care doctors.
While nearly half of the NEJM poll respondents say finding and hiring trained palliative/end-of-life care specialists is difficult, just over a third report that retaining them is equally challenging.
In an ideal world, each facility would have a dedicated palliative care team(s) to help patients and loved ones work through this challenging phase of life. There is a definite shortage of boarded palliative care physicians in the country, however, most facilities don’t have the financial or personnel resources to build out a full team.
"The lack of palliative care resources is the main reason we must do a better job of educating every physician on how to have these difficult conversations the right way through a standardized process," Dr. George says. "As with most anything in life, the more training and practice they have, the better they will get at it."
Persevering Through the Challenges
The question remains: How can hospitals persevere through the challenges and do their best to train physicians on how to have palliative care conversations well?
"The inability to have the 'perfect' scenario of a full palliative care team should not by any means hinder or discourage executives from prioritizing exceptional palliative care throughout the organization," Dr. George says. "There are plenty of affordable resources for provider training that you can execute within your organization."
Palliative Care Tools and Resources
Speaking of resources, here is a shortlist to consider when establishing a training program:
- Center to Advance Palliative Care - Tools, Training, and Technical Assistance for Clinicians
- Changing How We Think About Palliative Care
- The Conversation Project - How to Engage Patients and Families About End-of-Life Care
- Training Doctors to Speak Frankly About Death
- Having the Talk: When Treatment Becomes End-of-Life Care
- Conversation Starters: Research Insights from Clinicians and Patients on Conversations About End-of-Life Care
The ROI of Palliative Care
It’s clear that prioritizing palliative care creates higher quality experiences for patients and their families, but it can also deliver positive margin impact.
Because palliative care helps ensure that resources are matched to patient and family needs and priorities, it reduces inpatient readmissions, outpatient admissions, total costs to the hospital, overall waste, and physician burnout. In short, strong palliative care programs give patients, doctors, hospitals, and systems an effective solution to many of their most pressing challenges.
Palliative care has been shown to yield efficiency by replacing unnecessary and burdensome interventions with a coherent care plan driven by the patient's priorities. This results in lower costs for hospitals and payers, improved quality of life for the patient, better clinical outcomes, and greater patient satisfaction.
Isn't it time your hospital put a palliative care program into effect?
We have two resources that can help: Tip sheets—one for emergency physicians and the other for hospitalists—that are designed to expand your physicians’ knowledge and empower them with tools and resources to continue learning and improving their skillsets.