from the Center to Advance Palliative Care

Health consumers demand high standards of care and an active role in their treatment. Increasingly, hospitals are expected to deliver this level of care in the areas of pain and symptom management. In its annual ranking of hospitals, U.S. News & World Report now includes the presence of palliative care services in its evaluation criteria. Numerous studies of people with serious illness show they want the types of services that palliative care provides.

Patients want vigorous treatment of their pain and symptoms.

• Pain is the most common and widely feared symptom of hospital patients.
• Untreated pain results in medical complications, increased length of hospital stay, unnecessary suffering, increased use of health care resources, and decreased patient satisfaction.
• Over 90% of pain episodes and other symptoms can be effectively treated with standard analgesic therapies provided and closely monitored by a palliative care program.

Patients want relief from worry, anxiety, and depression.

• A leading symptom of patients with advanced illness is anxiety and depression.
• These sources of suffering can be effectively treated to promote the best possible quality of life for patients and their families.

Patients want communication about their care over time.

• Patients want a voice in their care.
• They want clear, ongoing communication with their physicians and other health care providers about what to expect and how to plan for their treatment and their future.

Patients want coordinated care throughout the multiple-year course of an illness.

• As patients live with advanced illness, they need help navigating the medical system and coordinating among their health care providers and care settings.

Patients want support for family caregivers.

• Seriously ill patients are anxious to reduce burdens on their loved ones and want help involving their family in care decisions.

Patients want practical support.

• Patients and families need help locating and accessing home health services, aides, nutrition support, and transportation.

Patients want a sense of safety in the health care system.

• Recent surveys show concern among patients about the possibility of medical errors and lack of coordination of their care during their hospital stays.
• Palliative care patients report feeling their care is closely monitored and well communicated.

Hospice Benefits to Hospitals Lower costs for hospitals and payers

Hospitals with palliative care programs find that:

• Patients are transitioned to appropriate levels of care. This transition often reduces length of stay, especially in the ICU.
• Proactive care plans expedite treatment. Hospitals can better plan daily resource use by following the agreed-upon care approach, often reducing costs for redundant, unnecessary, or ineffective tests and pharmaceuticals.
• They maintain high quality of care while increasing capacity and reducing costs through shorter lengths of stay and lower ancillary and pharmacy costs.

Leading hospitals recognize the challenge of caring for the seriously ill in the busy hospital setting.  Palliative care programs help address these issues by focusing on supporting the primary physician and nurse responsible for the care of these patients.
Palliative care teams provide physicians with:

• Time by helping with care coordination and time-intensive patient-family communication about the goals of care.
• Expertise in pain and symptom management, particularly for complicated cases where relief of symptoms is hard to achieve.
• Support for the plan of care by helping coordinate the treating physician's orders, including safe and effective discharge planning.
• Satisfied patients. Patients who receive palliative care as part of their overall medical treatment have a high level of satisfaction with their physicians, health care team, and hospital.

Providing patient-centered care increases patient and family satisfaction with hospital services and builds loyalty to the institution.

Given the complexities and fragmentation of today's health care system and the growing medical needs of the chronically ill, provision of well-communicated and highly coordinated care requires tremendous staff time and effort. Palliative care programs have been shown to help hospital staff provide this level of coordinated care for their patients, thus increasing staff job satisfaction and retention.
Palliative care programs assist staff by:

• Providing patient-family case management and coordination.
• Ensuring safe and effective management of complex and changing symptoms.
• Supporting and assisting physicians, nurses, and social workers in their efforts to provide the highest quality bedside care to patients and their families.