Palliative Care HSCC Has Launched

November 20, 2020 | 3 min. to read

Northwestern Medicine Palliative Care aims to improve quality of life for patients and their caregivers at any stage of a life-altering illness. Effective integration between specialties and palliative care services to support patients with complex needs is an important priority, says Martha L. Twaddle, MD, co-lead for the new Palliative Care Health System Clinical Collaborative that launched in September.
 
“HSCCs provide structure to standardize workflows, documentation and tools across the system,” Dr. Twaddle says. “We are engaging specialties in all regions because palliative care is a team sport.”
 
One of the group’s FY21 goals is to enhance documentation to improve quality and consistency of care and enable data sharing with the Palliative Care Quality Collaborative (PCQC). PCQC is a new national data registry that offers a way to generate reports, benchmark against other health systems and learn about best practice care delivery for seriously ill patients, says Palliative Care HSCC Co-lead Eytan Szmuilowicz, MD.
 
“Joining the PCQC allows us to collaborate on research and will make us more accountable in adhering to quality standards that are accepted across the country,” notes Dr. Szmuilowicz.
 
The team is working on documenting consult notes, treatment preferences, pain assessment and other information in Epic in a uniform way, and finalizing measures to submit information to the registry when they’re ready, says Kathryn Thomas, director of Quality.
 
Care Reliability: Reduce length of stay
Dr. Szmuilowicz is clinical sponsor of a Care Reliability pilot project underway to develop and implement a palliative care pathway to reduce length of stay for patients under hospital medicine care. Studies have shown that incorporating palliative care services early in a patient’s therapy for chronic or life-threatening illnesses can improve symptom management and quality of life, facilitate complex decision-making and ease caregiver stress, while reducing length of stay, emergency department utilization, readmission rates and healthcare costs.
 
Representatives from Hospital Medicine, Palliative Care, Health Informatics, Spiritual Care, Social Work and Quality are working together to create a system standard of care for palliative medicine while achieving desired results, says Becky Jose, performance improvement leader who is supporting the pilot. Success will be measured by length of stay, ICU length of stay, 30-day readmission rate and days on a ventilator.
 
Build PACT into Epic to align workflows across the system
In tandem with the Hospital Medicine HSCC and Nursing HSCC, the Palliative Care HSCC is working to eliminate paper processes in some sites and create Epic tools to support and align system PACT (Preference, Aligned Communication and Treatment) workflows. “Asking patients with serious illness about their goals of care is essential to understand how we can help them achieve an optimal quality of life, and can lead to more timely palliative care referrals,” says Barbara Meijer, Health Informatics nurse specialist. Suggested improvements to Epic include:
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• Build a PACT trigger tool flowsheet to replace the current paper process at some sites.
• Add PACT Service Type to the advance care planning note to make it easier to locate PACT conversation notes.
• Create a new PACT Consult Order and PACT Referral List to improve visibility of patients targeted for PACT conversations.

“Building a suite of Epic tools to facilitate the PACT workflow will improve efficiency and visibility of this process for nursing, social work, pastoral care, and Palliative clinicians,” Meijer adds. Dr. Twaddle says the opportunity to bring together Nursing and local Palliative Care representatives to create tools to identify and assess patients earlier who can benefit from this type of care is “amazing work. When we share resources across the system, we can help patients live well.”

For more information, visit NMI > System Initiatives > Health System Collaboratives.