Updated January 5, 2005
The Center for Patient-Focused Care of the West Los Angeles Veterans Affairs Medical Center has implemented a new program that improves end-of-life care for veterans diagnosed with terminal illnesses.
"Pathways for Caring" serves veterans diagnosed with inoperable lung cancer, advanced chronic obstructive pulmonary disease, end-stage liver cirrhosis or advanced congestive heart failure. Multidisciplinary teams develop care plans, called critical pathways, that provide patient education, informed goal-setting, continuity of care and comprehensive clinical and supportive services.
The project focuses on symptom control, psychosocial and spiritual care, advanced care planning and overall case management. Multidisciplinary teams, made up of doctors, nurses, social workers, clinicians and pastoral caregivers, work with volunteers from Compassion in Action to provide palliative care. Veterans who might otherwise be forced to die alone are now more likely to have companionship and comfort in their final days.
The new "critical pathways" are a set of protocols that integrate state-of-the-art, hospital-based care with home-based and hospice care. Trinity Home Health and Hospice provide home health care as needed, enabling patients to receive hospital-based as well as home or hospice care according to their needs.
Finally, the project contributes to a new end-of-life care curriculum for the University of California-Los Angeles School of Medicine, one of the nation's largest teaching hospitals. The center's cutting-edge computer system is measuring the effect of the project on patient outcomes, the quality of life's end and the cost of care contributing to national efforts to improve end-of-life care.
This demonstration project was featured at the 2003 NHPCO 18th Management and Leadership Conference:
The Journal of Palliative Medicine (October 2003: Volume 6, No. 5) features an article about this demonstration project titled "Palliative Care Management: A Veterans Administration Demonstration Project"
Web site: www.gla.med.va.gov
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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.