Chapter 2 highlighted the accomplishments of Parkland Health & Hospital System, a public hospital serving Dallas County, Texas. The Parkland Breakthrough Series team focused on improving patient access to palliative care services. Specifically, the team aimed to increase by half the number of medical oncology patients who received palliative care services before the last month of life. Palliative services were defined to include pain management, hospice referral, social and spiritual referrals, and primary care. This service was integrated into an existing team - another model for teams and organizations to consider.
To evaluate the program's success, Parkland measured:
The charts that show Parkland's success are given in chapter 2. For instance, the average number of days in which a patient received palliative care services went from 11 to 60, and the percentage of patients receiving services rose from 40 to 80. The Parkland team attributes its success to careful case management and weekly multidisciplinary team meetings. (See the appendix, page 299, for Parkland's referral flowcharts.)
The next step in Parkland's cycle will include a focus on improved patient understanding of hospice care, increased advance care planning, and better pain management. The service will also be expanded beyond the oncology unit.
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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 ].