Identifying Palliative Care Champions to Promote High‐Quality Care to Those with Serious Illness

Abstract

Leading medical authorities advocate for routine integration of palliative care for all major causes of death in the United States. With rapid growth and acceptance, the field of palliative care is tasked with addressing a compelling question of its time: "Who will deliver timely, evidence-based palliative care to all who should benefit?" The current number of palliative care specialists will not suffice to meet the needs of persons with serious illness. In 2010, initial estimates quantified the shortage at 6000 to 18 000 additional palliative care physicians needed to fully staff existing programs. Unfortunately, the predicted number of specialty physicians in 2030 will likely not be larger than the workforce in existence today. These findings result in a physician-to-serious-illness-person ratio of about 1:28 000 in 2030. 1 To address the workforce shortage, stronger alignment is needed between intensity of patient needs and provision of palliative care services. Such an alignment better harnesses the talents of those in a position to deliver core palliative care services (such as discussing goals of care with patients or managing their symptoms) while engaging palliative care specialists to address more complex issues. We introduce the concept of "Palliative Care Champions," who sit at the nexus between specialty palliative care and the larger clinical workforce. Acknowledging that the needs of most patients can be met by clinicians who have received basic palliative care training, and that specialty palliative care is not always available for those with more complex needs, there exists an important opportunity for those with additional interest to scale training and quality improvement to fill this void. J Am Geriatr Soc 67: S461-S467, 2019.

Palliative Care in the Community – The Role of the Resource Nurse

“…The results of this study reveal that both available time and organisation of the palliative care team constrains the function of the resource nurse. Kamal et al (12) , in the context of hospitals, stated that implementing a care champion network to improve quality requires system changes as well, eg allocating necessary time to talk with the serious ill patients about goals of care. The results showed that support from the ward nurse, and mutual trust between ward nurse and resource nurse is important.…”

“…The resource nurse is also supposed to work with system improvements related to routines, procedures and pathways, in addition to advising and guiding colleagues, disseminating new knowledge and initiating re ection (8). Parallel terms for the resource nurse in the Norwegian context are, in the international literature, the palliative resource nurse (10), link nurse (11) or palliative care champion (12).…”

Top Ten Tips Palliative Care Clinicians Should Know About Integrating Population Health Principles into Practice

“…A PC champion is a clinician who is interested in PC, has been trained to skillfully assess and manage patients' PC needs, and promotes the learning and use of PC skills (e.g., communication) as part of standard practice within their own specialty. 35 In a population-based PC delivery system, champions can play a critical role in closing gaps in care for patients with serious illness.…”

Why palliative care is the answer to the serious illness question in payment reform

“…Palliative care delivery comes in 3 levels: primary, champion, and specialty. 13 Primary palliative care is the common, fundamental palliative care delivered by every clinician to every patient with serious illness. It comprises basic symptom management and goal setting by which primary and specialty clinicians (eg, cardiologists, oncologists) are experienced and comfortable.…”