1. CRMC’s Palliative Care Program Regional Learning Collaborative April 2014

2. Rural Dilemma: How do we deal with it?

3.  Preparation:  Patient need, but no funding from Medicare/Medicaid  1115 waiver project approval  Learning:  1/13 - Organizational Meeting  4/13 – PC conference – Austin  5/13 – Medical Staff Education  6/13 – Home care staff education  7/13 – Community Outreach (Hospice volunteers, Lions, Rotary)  Program Start: September 1, 2013 CRMC’s Palliative Care Program Regional Learning Collaborative

4.  Service Utilization:  1 PC RN FTE  Social services, chaplain, and physician home visits as needed  Supply meds to those without a Rx plan or ability to pay  Supplies and labs provided  Communication/coordination with cancer treatments and local primary care physician  Time, travel, suffering, and utilization improvements CRMC’s Palliative Care Program Regional Learning Collaborative

5.  How we’re doing so far:  10 referrals  5 PC admissions  All cancer Dx  All male  Average age: 54 years  2 discharges (to hospice)  Related Category 3:  66% reduction in ER visits among PC patients (6 months prior versus 6 months following). CRMC’s Palliative Care Program Regional Learning Collaborative

6.  Thank You  Questions?  Contacts:  John Henderson – 940.937.9178 or jmh@childresshosptial.com jmh@childresshosptial.com  Denise Bentley – 940.937.9178 or dbentley@childresshospital.com dbentley@childresshospital.com CRMC’s Palliative Care Program Regional Learning Collaborative