Circles of Influence 2013

Organization: The Denver Hospice, Denver, CO. Innovation highlights were its strategic approach to the role of palliative care in health delivery, complex care management for the dual eligible, and strong partnerships in the community for care delivery, research and education.

Recent Achievements:

• Community partners have helped with research, funding for care for the uninsured and formalizing education about palliative care within the community and beyond.
• Internally, the hard work and innovative spirit continues as opportunities arise that position The Denver Hospice as a national leader in hospice and palliative care, advanced illness management and care transitions.
• Providers across the country searching for palliative care and advanced illness management care models have inquired about the services provided by The Denver Hospice.
• Presentations to professional organizations about the continuum of care and outcomes that align with the Triple Aim measures help us identify efforts that create excellence in operational management and care.
• Research projects, grants and pilots have provided validation for the past and opportunities for the future of The Denver Hospice. The future demands partnering with educational institutions and community organizations that includes innovative thinking as the future of health care becomes reality. The Denver Hospice will build on its past to continue to be a leader in advanced illness management and palliative care.

Award Impact: The Circle of Life Award has had positive impact for The Denver Hospice and has created a sense of pride within the company. We are honored to have received this prestigious award and have had the opportunity to celebrate with the people and organizations that support our vision and mission.

Preparation for the site visit was challenging in a positive way as accomplishments and innovations in the areas of care delivery, research and commitment to education were documented and reviewed. One of the most gratifying aspects was the inclusion of and support from many community partners who have contributed to the success of The Denver Hospice over the 35 years.

The Circle of Life Award helped us advance opportunities and open doors. It has helped build a level of confidence with potential contract partners whose interests include participating and collaborating for accountable care.

Organization: Hertzberg Palliative Care Institute, Mount Sinai Medical Center, New York, NY. Innovation highlights were its leading research and education, primary palliative care, and strong complementary therapies.

Organization: UnityPoint Health, Iowa and Illinois. Innovation highlights were its patients being followed across the continuum, data driven approach, and palliative care being integral to its accountable care organization.

Recent Achievements:

• In 2015 served 7,773 patients over nine regions (served 55 patients in two region in 2005)
• We now have palliative care metric reports for four consecutive years and can track our growth and performance improvement.
  • 40 % - 70 % reductions in pain and shortness of breath within 24-72 hours after consult
  • Three of nine regions exceed the UPH target of 10 % Consultation Rate in the hospital site of service (five regions exceed the national benchmark of 7 %)
  • Three of nine regions have achieved the target of a pre-consult median length of stay of 2 days. (Our internal study demonstrates a positive $2100.00 operating margin per patient for those seen by Palliative Care within the first 48 hours of hospitalization)
  • One region exceeds the hospice median length of stay for patients referred to hospice from palliative care
  • 31 % of inpatient PC patients are referred to home care (23.2 % UPaH and 7.9 % non-UPaH)
  • 49 % of inpatient PC patients are referred to hospice (37.3 % to UPaH and 11.4 % to non-UPaH)
  • 40% of community PC patients are referred to hospice
  • Cost Avoidance: demonstrated a 70 – 75 % reduction in hospital utilization and variable direct cost for 6 months post initial consult when compared to the 6 months prior to the consult! In our original study in 2012-2013 we demonstrated 50 % reduction. (When we examined the subset of the population that we had claims on, we did not see the subset utilizing services outside of UPH).

• Provided national presentations on use of telehealth in palliative care.
• Created a standard palliative care flowsheet across the hospital and ambulatory setting that utilizes evidence based tools which allows for trending of patient data over time and data extraction for metrics directly from the EMR. Presented at the Epic XGM conference and have published the build on their website. Now engaging in conversations with other providers to support a nation-wide PC database.
• Presentation at CMMI on the value of a palliative care program within an ACO

Award Impact: The Circle of Life Award continues to provide credibility and recognition at a national level for our palliative care program. We feel privileged to be among a prestigious group of ward winners and have appreciated the opportunity to collaborate with several of them. The site visit day was one of the best days of my career. We appreciate the many opportunities that have come our way because of this award.