Expanding Palliative Care to All Settings
By Jennifer Moore Ballentine
I’m not sure how November was picked for National Hospice and Palliative Care month, but perhaps it had to do with, traditionally, November 1st being All Saints’ Day and November 2nd being All Souls’ Day, the days in the western Christian calendar when we remember all the saints in heaven and all the souls departed from earthly life. As the days grow shorter and the winter descends (yes, even here in San Diego!), the holy days and the remembrance month give us a chance to contemplate why we do the work we do, and how, each day, we strive to do it better.
Thus, it is especially fitting that, just in time for our very own month, the National Coalition for Hospice and Palliative Care has published the long-awaited 4th edition of the National Consensus Project Clinical Practice Guidelines. The first revision of the guidelines since 2004, this edition represents several significant shifts in the practice and focus of palliative care, summarized in the press release on the NCHPC webpage. Notably, it makes a full-throated call for palliative care principles and best practices to be fully integrated into all care settings.
And guess what? We have exactly the curriculum and tools ready-made to assist clinicians to gain an understanding of palliative care, prognostication, advance care planning and sharing serious news, pain and symptom management, cultural intelligence, spiritual assessment and support, self-care, and – bonus – integrating palliative care into practice.
Appropriate for primary care providers, non-palliative specialists, hospitalists, referring physicians and others, our Primary Palliative Care Skills is a self-paced series of nine courses, comprising 34 content hours. It lays out the fundamentals of palliative care and provides practical strategies to help generalists better care for patients with serious illness, and more accurately assess when it’s time to refer to specialty palliative care or hospice.
Providers who have completed the course describe it as excellent, comprehensive and highly interactive. “I will definitely apply the pain medication conversion/calculation rules I learned, as well as the information on symptom management, and will try to address spirituality during my care of patients facing end-of-life issues,” one nurse practitioner said.
That’s music to our ears. While it’s gratifying that the updated NCP guidelines recognize the imperative to expand palliative care across all settings, real change relies on the clinicians, organizations, and payers who embrace and implement this vision. We’re thankful for those who have already done so, and eager to welcome and train up those who will heed the call.