1. Partners in Palliative Care Program JAMES LEE, MD THE EVERETT CLINIC EVERETT, WASHINGTON VELDA FILZEN, RN, BSN, CHPN, PARTNERS PROGRAM COORDINATOR PROVIDENCE HOSPICE AND HOME CARE OF SNOHOMISH COUNTY

2. What is Palliative Care? A philosophy of care –Prevent and relieve suffering –Quality of life –Personal growth An organized, highly structured care model –Enhancement to disease-based treatment –Assist with decision making –Rendered along with life prolonging treatment, or as main focus of care nationalconsensusproject.org

3. Question… “Would you be surprised if this patient died in the next one to two years?”

4. Current Healthcare State – Crisis Management So, where do many patients today turn when they have a health crisis? The HOSPITAL

5. One Solution: Palliative Care Program in Primary Care Office Setting Treatment options –Based on patient’s wishes and values –Face-to-face or electronic communication (EHR) Proactively avoiding crisis –Medical and social conditions addressed –Office visits when appropriate

6. Program Interventions  Program Referral  Assessment  Volunteer  Chaplain  Care planning w/MD and patient/family  Case/Symptom Management  Monthly contact by phone or home visit  Documentation  Data collection

7. Satisfactions Surveys for Partners Program PatientsVery High (4.8/5.0) ProvidersExcellent (5.0/5.0)

8. 2007 – Hospice Utilization PROVIDENCE HOSPICE N=898PARTNERS PROGRAM N=63 26 22 90

9. Hospital Admission Rate Date Range: 8/4/04 – 10/30/06

10. Our Goals  To empower patients in managing their end of life care  To increase  Primary care office case mgmt  Patient/provider satisfaction  Use of community resources  Hospice and home health referrals  To decrease  Unnecessary hospitalizations and ER visits

11. James Lee MD jlee@everettclinic.com Velda Filzen RN velda.filzen@providence.org