Clinicians with experience in end-of-life care often feel that establishing a palliative care program is not "rocket science" and is an effective way to manage care that will have positive outcomes for patients. These feelings by themselves are not sufficient to convince administrators and finance officers that launching a new program is a good business decision for the organization. And make no mistake — managed care is a business. Good ideas must be tied to sound business practices and quality management if they are going to get off the ground.
Hospice programs have demonstrated their cost effectiveness, but this fact also is not sufficient reason for an organization to develop a palliative care program. A systematic approach to analyzing need, assessing feasibility, and evaluating cost effectiveness is an essential first step to establishing a program. Funds for a new palliative care program may need to be diverted from other care delivery sites, whose staff members are likely to advocate strongly for their programs. Counter arguments in favor of developing a palliative care program must be clear, concise, and compelling; they should underscore the new program's potential to improve quality of care and life, while reducing overall costs to the organization. For the program to be successful, it must be supported not only by a visionary clinician who sees its value but also by other stakeholders in the organization, including administrators, staff, patients, and their families.
Conduct a needs assessment
Establish leadership
Develop program policies and procedures
Identify barriers to implementation — and strategies to overcome them
Craft a business plan
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For more information about the TriCentral Palliative Care Toolkit visit www.growthhouse.org/palliative/. All content is Copyright © 2002, 2003 by Richard D. Brumley, M.D. All rights reserved. No part of this toolkit may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without written permission from the publishers. This guide to developing home-based outpatient palliative care services was developed through a grant to the Kaiser Permanente TriCentral Service Area from The Project on Death In America. The Kaiser Permanente TriCentral Palliative Care Program is a Sustaining Member of the Inter-Institutional Collaborating Network On End-of-life Care (IICN) which links major organizations internationally.
