The program is part of the VA’s national strategy to improve end-of-life care. Bonnie Ryan, R.N., chief of VA Home and Community-Based Care, describes the VA’s major goals for improving care for dying veterans: to provide optimal pain management, to develop patient-centered care plans, to offer bereavement programs, and to promote access to hospice and palliative care services.
Each faculty leader wrote a proposal to develop a benchmark curriculum. As a group, they will identify the most effective proposal and help one another to implement it. The program will differ in each institution and will depend heavily on the influence of the faculty leader. The VA is particularly appropriate for such an endeavor because of its commitment to end-of-life care, its academic infrastructure, and its patient population (which is ten years older and more seriously and chronically ill than the general population).
During their first meeting in October, faculty leaders identified barriers to implementing the new curricula, including a resistance to change, lack of institutional support, the additon of end-of-life care to an already crowded training program, and reimbursement. Small groups planned methods to design, integrate, and implement a curricula while overcoming the potential barriers.
The project’s timetable calls for the development of local strategies in the next six months. In May, the second meeting will be held to define the benchmark curricula for end-of-life care, discuss which methods were successful locally, and reach a consensus on a broadly defined final prototype curricula. The second project year will involve fully implementing the curricula by June 30, 2000.
This program has the potential to make substantial changes in end-of-life care on a national level. Not only will the curricula train residents about end-of-life issues, it will establish a structure and focus to prepare the medical community to incorporate palliative care into daily practice.
Katie McGoldrick, an undergraduate at the George Washington University, works with ABCD’s policy and development office.
For more information, contact David P. Stevens, M.D., Chief Academic Affiliations Officer, at david.stevens@hq.med.va.gov; Judith Salerno, M.D., Chief Consultant, Geriatrics and Extended Care Strategic Healthcare Group, judy.salerno@hq.med.va.gov; or Bonnie Ryan, R.N, Chief, VA Home and Community Based Care, bonnie.ryan@mail.va.gov.
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This content is provided by Americans for Better Care of the Dying. For more information, visit www.abcd-caring.org.