Circles of Influence
Highlights of the Continuing Journey of Past Circle of Life Winners
2002
Organization: Children’s Program of San Diego Hospice and Children’s Hospital and Health Center (now called Rady Children’s Hospital and Health Center), San Diego, CA. The collaboration between the hospice and the children’s hospital included traditional hospice care, perinatal supportive care, and palliative care management.
The program was cited for its innovations in a compassionate extubation program, early intervention program for parents with prenatal diagnosis threatening to unborn baby, and use of pediatric hospice standard orders and program-specific guidelines.
Recent Achievements: The Children’s Program of San Diego Hospice partners with all the major health systems throughout San Diego and North County. It now has a family practice/pediatric physician on staff and supports two geographically-divided children’s care teams. In addition, the Children’s Program now offers pediatric palliative care consultation services at Rady Children’s Hospital, where relations are especially strong with hematology-oncology, pulmonary, and neonatal intensive care unit.
The perinatal hospice program now includes two other San Diego facilities—University of California San Diego Medical Center and Sharp Mary Birch Hospital for Women.
The hospice’s newest program, Partners for Children—a pediatric palliative care waiver program through the California Medicaid program— allows eligible children and their families to receive palliative care services during in the course of the child’s illness, while concurrently pursuing curative treatment for the child’s life limiting or life threatening medical condition.
The Palliative Medicine Fellowship Program at The Institute for Palliative Medicine at San Diego Hospice accepts physicians and nurses from all over the country and internationally. It has trained one family practice physician specializing in pediatrics, one pediatric oncologist, and three medical-pediatric physicians and is adding a neo-natal intensive care physician next year. The program has also mentored UCSD/Balboa Naval Medical Center residents; Rady Children’s nurses, social workers, nurse practitioners, and pain team specialists; and a child life specialist.
Award Impact: Pediatric palliative care is financially difficult, with the small volume of patients and costly palliative care interventions, and care is increasingly not reimbursed. Award dollars helped ensure continued existence and expanded services.
In additional, funds were used to train internal staff and external partners, as well as finance attendance at palliative care conferences.
The application gave the Children’s Program the opportunity to evaluate strengths and weaknesses of the program to best prepare for how to expand, improve, and continue services.
Organization: Hospice of the Bluegrass, Lexington, KY. The hospice was cited for its innovative bereavement groups for suicide and homicide deaths, specialized pediatric program available to rural families, and outpatient palliative clinic service.
Recent Accomplishments: The Palliative Care Center of the Bluegrass (a wholly-owned subsidiary of the hospice) is one of nine Palliative Care Leadership Centers, which provide intensive, operational training and yearlong mentoring for palliative care programs at every stage of development and growth. (The centers were established by the Center to Advance Palliative Care and the Robert Wood Johnson Foundation in 2004.) It is the most active of the centers, working with hospices extending their continuum into palliative care.
The hospice continues to collaborate with an increasing number of hospitals (now serving 32 counties) and is now partnering with the university on a fellowship. The hospice also provides an educational program with the hematology-oncology fellows and residents.
The hospice’s pediatric and bereavement programs continue to grow. Recently, the hospice hosted a statewide conference on suicide and continues community bereavement counseling (including for a plane crash about three years ago). The hospice has participated in some state Medicaid programs through its pediatric program and private duty nurse service.
Award Impact: The hospice credits the Circle of Life Award for its selection as a Palliative Care Leadership Center. The award added to the hospice’s prestige, and staff was thrilled to be recognized. The hospice still receives calls from other organizations asking about the Circle of Life Award. In addition, the award process helped the hospice think through its “stars” and “signatures.”
Organization: Project Safe Conduct of the Hospice of the Western Reserve and Seidman Cancer Center (formerly, Ireland Cancer Center), Cleveland, OH. The project was cited for its innovations in integrating a palliative care in a cancer center environment, moving palliative care upstream, and collaboration between a hospice and an academic medical center.
Recent Accomplishments: The provision of integrated palliative care within the acute care of cancer patients has continued. The Cancer Center formally assumed financial responsibility for the Cancer Support Team members after completion of the grant and extended the services provided by hiring a palliative care physician and making the services available to patients with all types of cancer.
Award Impact: Within the cancer center it was “quite something” to be part of the Circle of Life Award; the award was displayed in the cancer center’s showcase.
The team has had a major impact at Seidman Cancer Center. But it has also had an impact on other organizations. The then-director notes, as an impact of the Circle of Life Award, that there are to this day requests for a pain tool created by Project Safe Conduct and the model is highlighted in the Textbook of Palliative Nursing’s second edition and in the End-of-Life Nursing Education Consortium (ELNEC) curriculum.
Special Award Winner
Organization: Population-based Palliative Care Research Network (PoPCRN), University of Colorado School of Medicine, Aurora, CO. PoPCRN is a research collaborative to expand the palliative care knowledge base. Its innovation highlights were research conducted where care is given, collaboration with academic researchers, and focus on practical and policy issues.
Recent Achievements: The network has undertaken more than 35 research projects and since its inception has grown to include 991 individuals representing 339 hospice/palliative care organizations plus 134 non-clinical organizations, from 49 states and 11 countries. New areas of investigation since the 2002 special Circle of Life Award include symptom management and caregiver concerns. Today, the network receives funds from the National Institutes of Health, American Cancer Society, and foundations.
Award Impact: The Circle of Life Award increased the research network’s visibility, particularly within the University of Colorado Health Sciences Center. It carried validation that they were undertaking valuable work. The application and site visit made them examine who they were, what they did, and why they did it.
PoPCRN has helped hospices that are part of their projects apply for the Circle of Life Award, contributing insight on what makes these hospices innovative.
Award funds were used to host a convocation for participating hospices in conjunction with an NHPCO joint clinical conference in Denver, the network’s first full face-to-face meeting.