1. Community Based Palliative Care
Franciscan Hospice and Palliative Care
David Bucher
Manager of Palliative Care
October 11, 2016

2. ORGANIZATIONAL CONTEXT
CHI FRANCISCAN HEALTH
FRANCISCAN HOSPICE AND PALLIATIVE CARE
HOSPITAL BASED PALLIATIVE MED
COMMUNITY BASED PCO

3. The PALLIATIVE CARE OUTREACH STORY
FROM CASE MANAGEMENT TO CLINICAL CARE

4. PCO PEOPLE 7 PALLIATIVE CARE ARNPS I LICSW BORROWED HOSPICE CHAPLAINS
SUPPORT STAFF:
SHARED MEDICAL DIRECTOR
PALLIATIVE CARE MANAGER
2 OFFICE ASSISTANTS
PT REGISTRATION REP

5. LOCATION OF SERVICE Click to add subtitle THREE COUNTY GEOGRAPHY
PIERCE, KING & KITSAP
PATIENT HOMES
ASSISTED LIVING FACILITIES
ADULT FAMILY HOMES
SKILLED NURSING FACILITIES
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6. PALLIATIVE CARE SERVICES
Management of complex symptoms
Helping patients and families better understand their illness
Clarifying treatment goals
Addressing psychosocial burdens and spiritual distress
Facilitate transition to hospice when life expectancy is limited
Advocate for patients’ GoC.
Coordinate care with surrogate decision-makers and other health care providers
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7. SERVICES NOT PROVIDED Primary care Chronic pain management
Case management
Clinic based care
Hospice substitute
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8. REFERRAL SOURCES 7 CHI FRANCISCAN HOSPITALS OTHER COMMUNITY HOSPITALS
CHI FRANCISCAN MEDICAL GROUP
HOME HEALTH
HOME BASED PRIMARY CARE
LTC FACILITIES
SELF REFERRALS
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9. OPERATIONAL MEASUREMENTS
PCO DASHBOARD
2016 REPORTED MONTHLY
BILLABLE VISITS
PATIENT ADMISSIONS
REFERRALS TO HOSPICE
DEATHS
HOSPITAL ADMISSIONS
30 DAY READMISSIONS
REFERRAL TO ADMISSION (DAYS)
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10. CHALLENGES AND OPPORTUNITIES
SIGNIFICANT INCREASE IN REFERRALS
INCREASED PRESSURE FOR HEALTH SYSTEM REGARDING MORTALITY AND 30 DAY READMISSIONS
CLINICIAN RECRUITMENT – ARNPs are scarce
EXPANDING WITH MORE INTERDISCIPLINARY TEAM MEMBERS
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