In a keynote address, Karen A. Davie, President of the National Hospice Organization (NHO) told participants that a major challenge for all hospices is a "public and private reimbursement system that creates artificial barriers to achieving care."
"We should not define what we do around a benefit, we should not define what we do around a certification of prognosis," she said. To this end, the NHO is working to revise the Medicare benefit to include a prognosis of 12-months or fewer.
Davie also reported that NHO has established a Data Task Force "to quantify the hospice story for the American public." The group will soon release a report on hospice in skilled nursing facilities and has begun the process of creating a hospice accreditation program.
Beverly Tyler of Georgia Health Decisions reported on the study, "The Quest to Die with Dignity," released last year by American Health Decisions. Frank Brescia, M.D., tackled, "The Concept of Happiness in a World of Suffering," describing the process through which professional caregivers are able to maintain their humanity and hope despite the suffering they witness each day. Brescia, professor of medicine at the Medical University of South Carolina, compared providers’ feelings to those of Mary Poppins, who said, "What would happen to me if I loved all the children I said good-bye to?" Citing another film classic, "The Wizard of Oz," Brescia urged participants to remember that "competency counts." Unlike the wizard, who claims, "I’m a very good man, but a very bad wizard," hospice professionals must be good people AND good professionals.
Lester Shane performed his one-man show, "Mortal Coil," which portrays a dozen hospice patients and staff grappling with medical, social, emotional and spiritual challenges at the end of life. The performance offers a montage of voices and stories, from a 22-year old whose lover is dying of HIV/AIDS to an 87-year old Alzheimer’s patient in coma.
The symposium included awards for outstanding work by hospices around the state. The highest honor, the Award of Excellence, went to Hope Hospice and Palliative Care in Fort Myers for its work in bringing hospice services to cardiac patients in their community. Hope Hospice developed its project during its yearlong efforts with the Institute for Healthcare Improvement Breakthrough Series on Improving Care at the End of Life. Other winners included the Hospice of the Florida Suncoast for its pain management training program, and Tampa-based LifePath Hospice for its a community-wide newsletter. The Hospice Hero award was presented to State Representative Bob Brooks, a physician and policymaker who has sponsored legislation creating an opportunity for end-of-life care to be studied in Florida.
Many will remember this symposium as the Hurricane Symposium, but all are likely to remember it as an opportunity to share information and experiences, to hear from other programs around the state, and to look to the future as hospice creates a place for itself in the next century.
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