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Franciscan Health Systems, based in Tacoma, Washington, aimed to improve access to and increase patient satisfaction with supportive services. Franciscan's team took several approaches to increasing access to care, primarily by increasing provider referrals to hospice and supportive care. The group tested several approaches to encourage doctors to refer patients whose diagnosis of heart disease or cancer gave them a prognosis of less than 12 months to live.
The group found that the most effective way to get referrals was to show doctors a list of patients with serious diagnoses and ask, "Would you be surprised if this patient died in the next year?" Tactics that didn't work included a self-referral brochure for patients and a resource list in each exam room. Doctors and other staff who viewed the video "Supportive Care of the Dying," which describes the needs of dying patients, were more likely to increase referrals. Increased referrals had a significant effect on Franciscan's hospice:
Supportive Care program staff are based in the system's clinics, where their presence serves to remind clinicians that the program is available. Physicians can also continue to follow their patients.
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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 ]. |
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