Circles of Influence
Highlights of the Continuing Journey of Past Circle of Life Winners
Organization: Louisiana State Penitentiary Hospice Program, Angola, LA. Angola is widely viewed as one of the toughest prisons in the US—most inmates are serving life-time sentences. Average age of those in the prison is 42; average age of death is 52. The hospice’s innovations cited in 2000 were its inmate volunteer program; depth and breadth of the volunteer training program; impact of program on restoring respect and dignity to both patients and volunteers; multi-disciplinary teamwork, including security; support from prison clubs; and reliance on patient’s own definition of family.
Recent Achievements: The penitentiary continues to provide hospice care, and palliative care has moved upstream to other parts of the prison as well, so services are available before hospice is needed. Inmate volunteers have been trained and provide assistance in these areas as well.
Hospice and palliative care in the prison—and its use of prison inmates to ease the dying process—have improved conditions (decreasing violence and legal challenges), solidified the working relations between security and medical providers, provided models for other prison programs throughout the nation, and led to public attention for those facing natural death in prisons (including a photography exhibit and a film in development).
At the time of the award, Angola officials were helping export its successful model to two other prisons in Louisiana. The hospice staff continues to talk about its program throughout the nation and can point to other correctional institutions that have adapted Angola’s approach by letting inmates make it their own program.
Award Impact: The Circle of Life crystal resides in the prison’s museum, which is visited by 1,000 people monthly. Staff believes that recognition marked the organization as progressive and “good at what we do,” and in those ways helps reassure inmates they will be receiving appropriate end-of-life care.
Louisiana State Penitentiary Hospice used the award money both to mentor others in forming similar program and to improve its own program. Part of the award money purchased a notebook computer with CD-burner, so the hospice could send CDs with all of the program specifics, policies, forms, reference lists, tools, etc. to others. The LSP hospice also used the award money:
- for two volunteer banquets
- to send the team and several primary care nurses to several end-of-life seminars
- to have someone come in to provide education to more than 100 staff members
- to purchase educational books and tapes for the library and items for the chapel
- to design and print grief and hospice brochures
- to purchase a frozen drink machine to use as a fundraiser (the hospice is run strictly on donations by volunteers)
- to obtain medical supplies unavailable through the state
- to pay for an RN to prepare for and take the Certified Hospice and Palliative Care exam
- to purchase office supply items to assist in recordkeeping
Organization: Improving Care through the End of Life, Franciscan Health System, Tacoma, WA which delivered palliative care through the health care system’s clinics and physician offices. Franciscan Health System is a five-hospital system that is part of Catholic Health Initiatives.
The program staff devised the now well-known question for physicians, nurses, and others caring for patients with chronic and terminal disease: Would you be surprised if your patient were to die in the next year? This approach has in many cases dramatically changed how practitioners around the world view palliative care.
The program was cited for clinic-based services, extended patient support, advanced care planning process, community orientation, extraordinary reliance on community-based volunteers, and strong hospice linkages.
Recent Achievements: The clinic-based program eventually reached 11 Franciscan-owned clinics and a caseload of approximately 600 patients with RNs and chaplains providing clinic-based palliative care consultation.
Named Improving Care through the End of Life when it received the Circle of Life Award, the program believes its newer name, Palliative Care Outreach, defines its evolution—to include mid-level providers and open access to all community providers.
Following a recent restructuring, the program now has nurse practitioners and social workers providing home-based consultation. Referrals can come from any physician, whether part of the Franciscan system, or requests can come from anyone in the community.
The palliative care consultations have led to earlier and more appropriate hospice referrals and so have significantly increased the time patients and families benefit from hospice services.
Franciscan is currently working to close the “disparity gap” in end-of-life care, with outreach in its service area to diverse populations that typically underuse hospice and palliative care.
Award Impact: The award gave credibility to what the program had accomplished. Following the award presentation, four hospice programs in Washington, Oregon, and Louisiana purchased the program’s initiatives, policies, procedures, and forms, and the program staff mentored them for a year or longer until they were fully operational. Award funds were used for program development, marketing brochures, and physician education on palliative care for patients with chronic and terminal conditions. The program has received several additional awards and grants since it received the Circle of Life Award.
Organization: Called The Hospice of the Florida Suncoast (The Hospice) when it received the Circle of Life Award in 2000 (now known as Empath Health in which Suncoast Hospice is a member), the Clearwater-based organization cared for 4,700 people a year, employed 850 staffers and welcomed the skills of 2,600 volunteers to help support its mission of community care and service. The hospice was cited for its creative community programs, Quality of Life fund, intergenerational volunteer program, children’s camp for bereaved children and family-to-family retreats, palliative care, hospice reference tools, hospice software and its Lifetime Legacies program, featuring high school student volunteers trained to capture patient stories and memories on videotape.
Recent Achievements: In the 15 years since Empath Health received one of the first Circle of Life Awards, it has remained firmly rooted in its commitment to providing care and services that meet community and individual needs by providing life-changing health care and expanding services and programs for various times in their lives including a PACE program, palliative consult services, integrative medicine clinic and a partnership to create an HIV medical home. Empath Health now employs more than 1,300 and has the support of more than 3,000 volunteers in roles throughout the agency.
In 2013 Suncoast Hospice opened its Integrative Medicine Clinic at its Clearwater campus providing complementary therapies for pain and symptom relief for hospice patients. The clinic has expanded hours of operations because of the services popularity.
Empath Health and member Suncoast Hospice continues to partner with area hospitals, long-term care facilities and long-term care/retirement communities with the goal of providing hospice services earlier. The organization has established palliative care consult programs under the Empath Health brand for those with serious illness and help with pain and symptom management, care coordination with the goal of a better quality of life. These services are available inside and outside of hospital settings.
Empath Health’s children’s programs offer hospice, palliative and palliative home health services as well as specialized bereavement services. Suncoast Hospice was one of the first hospices in Florida to participate in the Medicaid pediatric palliative care waiver program called Partners in Care: Together for Kids, which provides pain and symptom management from a physician, counseling, personal care and respite. The program has tripled the number of children served and connected them more directly with the services and care they need.
Other Empath Health Members
Empath Home Health, is a palliative home health service providing skilled care to homebound patients facing advanced illness or conditions. Patient care and support ranges from pain and symptom resolution through a team approach directed by physicians and the care of nurses, trained home health aides, social work/family services and trained volunteers.
Empath Choices for Care is a community resource for individuals, families and all others in need of guidance with advance care planning and living wills. Empath Choices for Care was a leader in providing POLST to hospice patients and involved in an innovative partnership with the Diagnostic Clinic helping patients and families realize the importance of advance care planning.
Suncoast PACE (Program of All-inclusive Care for the Elderly) provides comprehensive health care and support services to Pinellas County seniors with chronic health conditions. The program, which helps its enrollees remain in as independent as possible, opened a state-of-the art day care and medical clinic in 2013.
AIDS Service Association of Pinellas, Inc. (ASAP) provides support for those infected and affected by HIV/AIDS. ASAP offers case management, education, testing, counseling and a food and personal needs pantry. ASAP’s dedicated staff is available for education and testing in numerous locations throughout the Tampa Bay area. Through a recent partnership with the Pinellas Care Clinic, ASAP is bringing the first HIV medical home to the Tampa Bay area called Home 3050.This medical home will bring expert medical care, social support services and pharmacy services under one roof.
Award impact: Empath Health was honored and, at the same time, challenged by the Circle of Life Award. The award has become a reminder – stressing the importance of not being insular, choosing instead to study how hospitals, physicians, communities and individuals view end-of-life care, constantly seeking ways to better serve patients and families. The leadership of community hospitals expressed pride in their partnership with Suncoast – a partnership focused on joint service to members of the community.
In assessing the Circle of Life Award’s impact on fundraising, it is noted that fund granters look to mission and achievement as sources on which to base reassurance to others interested in supporting a given program. For individual donors, the high profile of the award reinforces that Empath sets high standards of care, innovation and quality – a national model in its field.
Award monies were used to strengthen linkages with community partners, including schools, physicians and hospitals. Funds also were directed toward research and development of new children’s and palliative care services.
The outstanding memory for team members about the award process is the Leadership Summit award presentation. The team was gratified to find that the progress and achievements they celebrated among themselves were now recognized and celebrated by others. They recall being humbled, excited and proud. They say their hope is that new award recipients will also experience the sense of fulfillment and achievement the award signifies.
The Circle of Life Award has inspired the existence of a special fraternity – one that Empath Health leadership believes opens hearts and minds to lessons to be learned from fellow recipients.