Steven (Skip) Radwany, MD, FACP, FAAHPM, is the Medical Director of Summa Health System’s Palliative Care and Hospice Services, and Professor of Medicine, Northeastern Ohio Universities Colleges of Medicine and Pharmacy. Dr. Radwany is the AAHPM Ethics, Advocacy and External Awareness Strategic Coordinating Committee Chair. This comes in follow-up to my post a couple of … Read moreLessons Learned at the ACP Meeting: Where do we go from here?
The Journal of Pain and Symptom Management is pleased to announce a call for papers that report the results of Quality Improvement initiatives in palliative care. This publication of brief reports is a joint project of the American Academy of Hospice and Palliative Medicine and the National Hospice and Palliative Care Organization. Papers focusing on … Read moreJPSM Call for QI Papers Closes April 15
Last week, President Obama declared April 10-16 National Volunteer Appreciation Week (April 10-16, 2011). In the proclamation, he states: America’s story has been marked by the service of volunteers. Generations of selfless individuals from all walks of life have served each other and our Nation, each person dedicated to making tomorrow better than today. They … Read moreAppreciating Our Volunteers
A Palliative Care Summit was recently convened in Philadelphia by the School of Population Health at Thomas Jefferson University. It was described as the “First National” and the “Leading Forum on Palliative and End-of-Life Care”. An impressive array of speakers over the two days. Diane Meier,MD, Sean Morrison, MD, Don Schumacher, David Wennberg, MD, Christine … Read more30/30/30 Campaign to Improve Late-Life Care
This past fall my husband had several hospitalizations, culminating with the planned re-admission for surgery which we thought would pretty much clear up his recent problems. The day of surgery, we had no clue that his surgery would take over 7 hours, and end in him being placed in the ICU. But even then, I was positive that it was just overnight after a prolonged aesthetic. It wasn’t, it was the start of a two week nightmare that found me floundering. While I work a a very large Academic Medical center, Palliative Medicine is still in its infancy. So our Service consists of me and my NP( and of course SW and Pastoral Care). At the end of the first week, knowing my husband’s feeling about life prolonging care, I began to get concerned about who would I look to, if I needed advocacy as the patient’s wife? I called Pal 4 Med. I don’t recall the name of the doctor who spoke to me, listened to me cry, and provided both solace and suggestions, but she was great! And she called back several days later, too. I was able to think more clearly and make some plans. I even was able to suck up the courage to take my boards . Yes, he was still on the vent on Nov 16th, when the exam were administered, and my brain was Swiss cheese, but the testing center was only 2 miles from the hospital and my sons stayed with him, while, I played with the computer.
We [the CMS] believe the role of the physician within hospices has been undervalued, and we would like to see the physician’s participation increase in the care of long-stay patients. That’s one of the messages to take away from the CMS regulation mandating physician (or nurse practitioner) face-to-face encounters to certify a patient’s continued hospice … Read moreHow Often Should Patients with Advanced Illness Be Visited By a Physician?
Although it was painful to get up so early on the final day of the AAHPM Assembly in Vancouver, it was completely worthwhile to attend the meeting of the Pediatrics Special Interest Group (SIG). Over the years that I’ve attended this meeting, it’s been amazing to watch the evolution of interest and attendance in our … Read morePeds SIG Offers New Avenues for Involvement in the Field
How AAHPM relates to other organizations such as ACP, ACS, AAFP, AAN and AAP is something our members and leadership will further address over time. AAHPM staff have created a grid for the External Awareness Task Force of the external relationships that already exist and the nature of those relationships. Again, our members and leadership will decide how these relationships should be prioritized over time and what the nature of these relationships should be. Should there be liaison representation on the boards of some of the large organizations? Is that an appropriate way for hospice and palliative medicine to become more entrenched in the firmament of organized medicine? What will be the most efficient and effective way for AHHPM to utilize its limited resources in developing these relationships? Where do we get the most bang for the buck so to speak?
Four Seasons Hospice has taken the plunge and begun to participate in the Physician Quality Reporting Initiative (PQRI) of Medicare. Since fall 2010, we have successfully been submitting data on three PQRI measures: #47 (Advance Care Plan), #154 (Falls risk assessment), and #155 (Falls plan of care). Our palliative care program extends across the inpatient … Read moreDiving into the Alphabet Soup of PQRI
This is Part 2 of a multi-part series.
Approximately 1 week into her ICU stay, when my mom wasn’t making any progress on ventilator weaning, I was called by the palliative care team asking if they should “formally” consult. They had been visiting daily but not officially consulting – introducing themselves as “Jean’s friends” – who happened to be from palliative care. The ICU attending had tacitly agreed to the consult, telling the palliative care team, “whatever Jean wants”. My initial reaction was no, we didn’t need that, we knew that she potentially could have a poor outcome and were talking openly about it. If anything, I told the palliative care team, my dad needed a ray of hope, not a discussion about the “what if’s”. It was an eye-opening moment for me – to consider the “meaning” of requesting an official palliative care consult and to confront my own perceptions and biases, despite intellectually knowing better. Was I falling into the same “it’s not time yet” mindset that frustrates us so frequently as palliative care professionals? Why would making it “official” be any different from the daily visits that the team was already doing? How would my dad and my siblings perceive my request for an “official” palliative care consult? Would they think that I had “given up” by recommending a palliative care consult? Why didn’t I trust what we do so well in palliative care – starting with assessing the patient (if able) and family understanding of the current situation and addressing identified needs? Why couldn’t palliative care be as much about “hoping for the best” as it is about “planning for the worst”? I told the palliative care team that they needed to “hit me over the head” if I was in denial or not thinking rationally about this clearly reasonable request.