Baystate Medical Center
"The Renal Palliative Care Initiative"
This program centered at Baystate Medical Center in Springfield, MA cares for patients in eight dialysis centers in western Massachusetts. The staff guides patients through advance-care planning and helps them confront hard issues, including the possibility of eventually discontinuing dialysis. Each month, the staff reviews recent deaths in morbidity and mortality conferences and learns the details of patients' last days, a tradition RPCI adopted from the hospital's surgery department. It is now routine for staff members to place a rose and a note in the dialysis center to honor a patient who has died, and each year hundreds of families from the region come together for an ecumenical memorial service for loved ones they have lost.
Comprehensive Cancer Center, University of Michigan
"Palliative Care Program"
The University of Michigan's Comprehensive Cancer Center, in collaboration with Hospice of Michigan, a nonprofit statewide organization, closely monitors quality-of-life and symptom management for cancer patients while they are undergoing disease-modifying treatment. The Palliative Care Program is bringing palliative care to patients with advanced prostate, lung, and breast cancer, and is improving the quality of life for them and for their families.
Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center
"Project ENABLE: Educate, Nurture, Advise, Before Life Ends"
The Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center has moved high-quality end-of-life care into New Hampshire's regional cancer center and beyond, into three rural communities. The ENABLE team assesses the needs of the patients, coordinates services and provides palliative care throughout the course of cancer treatment. Patient education is a priority, including a unique educational seminar, "Charting Your Course: A Whole Person's Approach to Living with Cancer." The course empowers cancer patients and their families to retain control of key decisions and of their lives.
Hospice of the Valley
"PhoenixCare"
This project of Hospice of the Valley is a collaboration with several large managed-care organizations in Phoenix, Arizona. The program serves patients with cancer, congestive heart failure, and chronic obstructive pulmonary disease, and brings key components of hospice care to patients at a much earlier stage than traditional hospice. Early on, the work begins with outreach care in patients'
homes. When patients are closer to death, an "enhanced care team" brings intense clinical intervention. Researchers are comparing the quality of life, satisfaction with care, and costs of the extended palliative care with data from patients with similar conditions who received traditional care.
Ireland Cancer Center: University Hospitals & Case
Western Reserve University
"Project Safe Conduct"
Case Western Reserve University Hospitals of Cleveland, in conjunction with Hospice of the Western Reserve has established a palliative team within the Ireland Cancer Center. The Project Safe Conduct team offers patients and families a guide to this labyrinth of treatments and services, emphasizing state-of-the-art symptom management as well as psychosocial and spiritual support. The project creates a system for end-of-life care that allows patients to receive life-prolonging care, including experimental
therapy protocols integrated with palliative care. The project is studying the impact on patients, families, clinicians and the participating institutions.
Louisiana State University Medical Center
"PalCare: End-of-Life Care for Persons with AIDS"
This program at Louisiana State University Medical Center is an end-of-life initiative for some of the least fortunate residents in New Orleans. These are people who not only have HIV disease but are often dealing as well with problems of addiction or mental illness. The PalCare team treats these symptoms while coordinating services with a care-management system. The team supports these patients with end-of-life planning and clarification of goals, while addressing psychosocial, spiritual, cognitive, and neurologic status, and clinical symptoms.
University of California, Davis, School of Medicine
"Simultaneous Care"
The West Coast Center for Palliative Education at the University of California, Davis School of Medicine provides palliative medical services to UC Davis Cancer Center patients who choose to participate in experimental cancer clinical trials, which usually make them ineligible for hospice services. This action improves patient's quality of life while they are undergoing experimental therapies.
University of Chicago Medical Center
"PEACE: Palliative Excellence in Alzheimer Care Efforts"
The University of Chicago Medical Center and the Hospice of Michigan extend palliative care to people with Alzheimer's disease and their families. With interviews, audiotapes, and teams of palliative-care specialists, this program helps guide patients and families who are forced to deal with extremely difficult care-giving challenges. In Chicago, PEACE is centered within an academic primary-care
geriatric practice. In Greater Detroit, the PEACE team provides care for patients with dementia in nursing homes.
Comprehensive Cancer Center, University of Michigan
Baystate Medical Center
Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center
Ireland Cancer Center - University Hospitals & Case Western Reserve University
Louisiana State University Medical Center
University of Chicago Medical Center
Hospice of the Valley
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Promoting Excellence in End-of-Life Care is a national program of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.