Preparing today’s health care workforce to meet future palliative care needs
By Angela Hult
Executive Director
Cambia Health Foundation
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Original Publish Date: January 14, 2014
At the recent Cambia Health Foundation Sojourns Awards and Palliative Care Summit, Dr. Diane Meier, who leads the Center to Advance Palliative Care, told the story of “Mr. and Mrs. B.” Mr. B is an elderly man with dementia and other health issues. Facing another trip to the hospital – which had become a regular occurrence – he simply refused to go. His wife, exhausted and overwhelmed as his primary caregiver, didn’t know what else to do except call an ambulance. Once they arrived at the emergency room, a staff member recognized the need to develop a personalized, integrated palliative care program to support Mr. and Mrs. B and provide them with the care they need.
Palliative care: demand is growing
Palliative care is a type of medical care that focuses on reducing the pain and suffering associated with serious illnesses. It provides an extra layer of support, addressing physical, intellectual, emotional, social and spiritual needs, while facilitating patient autonomy, access to information and choice. In response to his unique needs, Patient B’s palliative care team laid out an integrated care plan designed to help him maintain his quality of life by integrating his medical care, social support and spiritual needs, including visits from the couples’ church, Meals on Wheels and walks with a community health worker and a visiting doctor’s program. He has not been hospitalized since that trip to the ER and his wife is receiving the support she needs, which reduces her stress and also improves her quality of life.
This story illustrates the benefits of palliative care, in addition to the growing demand throughout the United States. By the year 2020 there will be approximately 74 million people over the age of sixty-five living in the U.S. Eighty percent of those people will suffer from at least one chronic disease, resulting in pain, symptom burden and increased suffering.
Yet there are too few health care professionals trained to provide palliative care in the face of this growing need. Where there is approximately one cardiologist for every 71 persons experiencing a heart attack and one oncologist for every 141 newly diagnosed cancer patients, there is only one palliative medicine physician for every 1,200 persons living with a serious or life-threatening illness. The lack of access to training inhibits workforce development: in 20 out of 50 states, there is no access to post-graduate training in palliative care.
Meeting future need
The Cambia Health Foundation is partnering with some of the Northwest’s leading health organizations to prepare today’s health care workforce to meet the growing demand for palliative care. These efforts include the annual Sojourns Award, which honors leaders and innovators in the field of palliative care. Award recipients receive a $50,000 unrestricted grant to advance their work. The Foundation is leveraging the success of this awards program with the national launch of the Sojourns Scholar Leadership Program in January 2014. This new initiative is designed to identify, cultivate and advance the next generation of palliative care leaders. The program seeks to support outstanding emerging faculty and clinicians by investing in their professional development. Sojourns Scholars receive $180,000 in funding to conduct an innovative impactful clinical, research, education or policy project in the field of palliative care.
The Foundation also invests in programs designed specifically to address existing gaps in palliative care training and workforce development. Cambia Health Foundation recently awarded a two year, $250,000 grant to Franciscan Hospice and Palliative Care for the creation of a training academy to educate physicians, nurse practitioners and physician assistants in generalist palliative care principles. The Palliative Care Academy will provide education and support for practicing clinicians, enhancing their quality care of patients. A grant of $697,000 to the University of Washington will be used to develop a collaborative Palliative Care Training Center over the next three years. The University will develop an interdisciplinary curriculum that will be implemented by expert faculty, and create a business plan that will sustain the Center for the long term. Expert faculty includes two former Cambia Health Foundation Sojourns Award Winners: Drs. Anthony Back and Darrell Owens. The Center of Excellence will be led by 2013 Sojourns Award winner J. Randall Curtis, M.D. As an author of more than 200 peer-reviewed articles and over 100 editorials, Dr. Curtis’ research has led to innovations in education, communications and palliative care in both the intensive care unit and the outpatient setting.
Pacific Northwest leaders like Drs. Back, Owens and Curtis are forging a path to the future of palliative care – and health care – by preparing today’s health care workforce for a new paradigm. These kinds of collaborative efforts will result in integrated, patient-focused care that honors a patient’s wishes and preferences when facing a life-limiting illness, the kind of care that represents the essence of a truly transformed health care system.
Angela Hult is the executive director of the Cambia Health Foundation, the corporate foundation of Cambia Health Solutions, a total health solutions company dedicated to transforming the way people experience health care. Learn more at www.cambiahealthfoundation.org or @CambiaHealthFdn on Twitter.