Sourcebook : Improving Care for the End of Life : 8.2 Building a Model That Works

Several models exist for palliative care programs in hospitals: dedicated inpatient units, palliative care experts, consultative services, or some combination of the three. Some programs rely on a nurse practitioner to coordinate care throughout medical-surgical wards; others rely on a team of physicians to make consults. Some programs have a very structured mechanism to receive referrals; others use physician outreach and networking for referrals.

Key Features of Palliative Care Consultations

Assessing, preventing, and relieving physical and emotional symptoms
Helping patients identify personal and treatment goals
Assessing and addressing psychological and spiritual needs
Mobilizing support for the patient’s personal and family resources
Estimating and communicating prognosis
Assisting in making discharge plans
Educating patient and family on self-management and use of community and other resources

Source: Weissman, 1997

8.2.1 Case Study - Northwestern Memorial Hospital
8.2.2 Case Study - Memorial Sloan-Kettering
8.2.3 Case Study - Detroit Receiving Hospital
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.

For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].