Community Based Palliative Care Franciscan Hospice and Palliative

Community Based Palliative Care Franciscan Hospice and Palliative Care David Bucher Manager of Palliative Care October 11, 2016

ORGANIZATIONAL CONTEXT CHI FRANCISCAN HEALTH FRANCISCAN HOSPICE AND PALLIATIVE CARE HOSPITAL BASED PALLIATIVE MED / COMMUNITY BASED PCO 2

The PALLIATIVE CARE OUTREACH STORY FROM CASE MANAGEMENT TO CLINICAL CARE / 3

PCO PEOPLE • 7 PALLIATIVE CARE ARNPS SUPPORT STAFF: • I LICSW • BORROWED HOSPICE CHAPLAINS / SHARED MEDICAL DIRECTOR PALLIATIVE CARE MANAGER 2 OFFICE ASSISTANTS PT REGISTRATION REP 4

LOCATION OF SERVICE Click to add subtitle • THREE COUNTY GEOGRAPHY – PIERCE, KING & KITSAP PATIENT HOMES ASSISTED LIVING FACILITIES ADULT FAMILY HOMES SKILLED NURSING FACILITIES / Presentation Title 5

PALLIATIVE CARE SERVICES • Management of complex symptoms • Helping patients and families better understand their illness • Clarifying treatment goals • Addressing psychosocial burdens and spiritual distress • Facilitate transition to hospice when life expectancy is limited • Advocate for patients’ Go. C. • Coordinate care with surrogate decision-makers and other health care providers / Presentation Title 6

SERVICES NOT PROVIDED • Primary care • Chronic pain management • Case management • Clinic based care • Hospice substitute / Presentation Title 7

REFERRAL SOURCES • 7 CHI FRANCISCAN HOSPITALS • OTHER COMMUNITY HOSPITALS • CHI FRANCISCAN MEDICAL GROUP • HOME HEALTH • HOME BASED PRIMARY CARE • LTC FACILITIES • SELF REFERRALS / Presentation Title 8

OPERATIONAL MEASUREMENTS PCO DASHBOARD 2016 REPORTED MONTHLY BILLABLE VISITS PATIENT ADMISSIONS REFERRALS TO HOSPICE DEATHS HOSPITAL ADMISSIONS 30 DAY READMISSIONS REFERRAL TO ADMISSION (DAYS) / Presentation Title 9

CHALLENGES AND OPPORTUNITIES • SIGNIFICANT INCREASE IN REFERRALS • INCREASED PRESSURE FOR HEALTH SYSTEM REGARDING MORTALITY AND 30 DAY READMISSIONS • CLINICIAN RECRUITMENT – ARNPs are scarce • EXPANDING WITH MORE INTERDISCIPLINARY TEAM MEMBERS / Presentation Title 10