Accelerating Change: Community-Based Palliative Care in Public Hospitals

Accelerating Change: Community-Based Palliative Care in Public Hospitals

The California Health Care Foundation's efforts to help develop sustainable inpatient and community-based palliative care (CBPC) programs in California's public hospital system have increased access to palliative care delivered in outpatient clinics, office practices, private residences, skilled nursing facilities, and assisted living facilities, a report from the foundation finds. According to the report, Accelerating Change: Community-Based Palliative Care in Public Hospitals (17 pages, PDF), CBPC services allow people with serious illness to get the support they need earlier than inpatient palliative care services alone and provide important continuity of care for those who are at risk for repeat hospitalizations and emergency department visits. After assisting California's seventeen public hospitals in developing, expanding, and/or enhancing inpatient palliative care programs, with a focus on reaching diverse communities (2008–13), CHCF launched the Community-Based Palliative Care in California Public Hospitals: Supporting Next Steps initiative (2015-19) to help hospitals develop a business case and clinical service plan for outpatient palliative care and share their learning through a learning community. The report found that, given the challenges presented by resource constraints common to public hospitals and the complex economic and social challenges many patients struggle with, program success required creativity, adaptability, and persistence. With mounting evidence linking early palliative care to improved quality outcomes and cost savings at the end of life for patients with cancer, teams encouraged specialists to refer patients to palliative care clinics and also ensured that discharged palliative patients were seen for follow-up and continuity.

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