Circles of Influence 2009

Organization:  Four Seasons, Flat Rock, NC. Innovations cited were leading-edge palliative care delivery in rural setting, collaborative research with university, and palliative care outreach.

Recent Achievements:

• > 5600 palliative care patients enrolled in Center for Medicare & Medicaid Innovations grant (9.6 million palliative care grant)
• Approaching 40th year of providing the right care at the right time to patients and families in western North Carolina
• Currently providing a continuum of care services including Care Navigation, Home Care, Palliative Care, Hospice, Bereavement Support and Clinical Research to Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Polk, Swain and Transylvania counties.
• Building and sustaining reputation as the provider of choice, trust and innovation.
• Continued to build loyal partnership with Mission Health by managing and growing the Palliative Care Program and UNC Pardee’s Home Health program. (we are no longer managing home health)
• Acquired Compassionate Home Care to further our scope of care for our patients and families.
• The Four Seasons Consulting Group offerings expanded to include consulting, management and training in unique subjects such as our “Inpatient Unit” Immersion course and How to Build and Sustain a Palliative Care Program.
• The Palliative Care Immersion Course continues to serve nationwide clientele
• Research & Development has successfully conducted over 45 studies since its inception in 2005 and received more than 5 grants with several others pending. We strive to conduct and develop innovative projects through sponsor collaborations and grant funding to enhance the services and care that Four Seasons provides.
• Now providing a telehealth remote patient monitoring program to hospice and palliative care patients in rural WNC
• Secured the future of the organization with establishment of The Four Seasons Foundation, the philanthropic branch of Four Seasons.
• In 2017 Four Seasons co-founded Teleios Collaborative Network (TCN) with a  purpose to allow not-for-profit hospices (Members) to leverage best practices, achieve economies of scale and collaborate in ways that better prepare each agency to participate in emerging alternative payment models and advance their charitable missions. As of July 2018 TCN has five members and covers more than 46 counties across North Carolina.

Award Impact: The award and its re-presentation in the community sparked an organizational renaissance — as the hospice re-emphasized connections to the community and the value of those relationships. It has also led to greater outreach and collaborative opportunities with our community partners, old and new.

The award process was a value-added process for Four Seasons; anything that encourages looking inward we feel is worthwhile. Preparing for the site visit helped the organization realize the amazing accomplishments we had achieved but also the opportunity and room for growth far into the future.

It is believed that the Circle of Life Award has heightened the awareness of the wonderful services that Four Seasons offers; thereby maintaining community support in a trying economy and growing the service lines and service areas supporting our mission in western North Carolina.

Organization:  Oregon Health and Science University Palliative Medicine and Comfort Care Program, Portland, OR. 

Program innovations include a focus on broadening palliative care, strong research and education elements, collaborative work and state-wide efforts.

Award Impact:  Because receiving the Circle of Life Award entails sharing the organization’s knowledge, the program has been more mindful to make time for collaboration.  It has worked with a Los Angeles veterans’ system on a dyspnea project and participated in several local research programs.

The award helped the program in requesting administration support for a slight change in medical directorship rotation—the administration was very interested in the program’s views, supplied a quick response, and mentioned the Circle of Life Award in its response.

The application was long but beneficial—it required the program to gather information in one document and helped it think about the future.

Organization:  Wishard Health Services (now known as The Sidney & Lois Eskenazi Hospital of Eskenazi Health) Palliative Care Program, Indianapolis, IN. 

The program was cited for continuity and comprehensive end-of-life care using limited resources, outreach throughout the hospital areas, and holistic approach to care for the poor and dying poor.

Recent Achievements:  On July 16, 2011, Wishard's Palliative Care Team embarked on a second Ride to Remember (R2R2).  Unlike the original 40-day cross-country bicycle ride that Gregory Gramelspacher, MD, completed in 2009, this year a Wishard Bike Team was assembled to ride across Indiana in a day-one way, one day, 160 miles!  As before, each mile was dedicated to the memory of one of the palliative care team's patients.  

2010 brought several changes to Wishard Health Services Palliative Care Program. 

• Since January 2010 the team's physicians have provided consultative services in the oncology clinic, increasing the volume and timeliness of palliative care.  The multidisciplinary approach has also proven to be more convenient for the patients and has further improved continuity of care for patients previously known to the palliative care team from hospitalizations.
• In the spring of 2010 the team created and implemented a robust Access database to track patients, improving the team's ability to track quality measures, identify trends, and create reports.  The database has significantly aided effort to provide interdisciplinary assessment between clinical encounters as well as bereavement services.   
• The Palliative Care Bereavement Program has been expanded with the help of a volunteer.  Future program enhancements will include No One Dies Alone, art therapy, and remembrance/memorial service.
• In March, Dr. Gramelspacher was recognized by the Indianapolis Business Journal as one of its Health Care Heroes in the physician category.  The award honors a physician whose performance on the job is considered exemplary by patients and peers.

Award Impact:  Sidney and Lois Eskenazi contributed one of the greatest philanthropic gifts ever to the people of Central Indiana, and one of the largest gifts ever made to a public hospital in the United States. The Eskenazis contributed $40 million for the new Wishard hospital facilities.

"This hospital and health system affect so many lives in such a positive way, especially those of our community's most vulnerable populations, that we feel it has no equal and offers us the greatest opportunity to contribute to the entire community," said Lois Eskenazi. "In the process of learning everything we can about this institution, we have fallen in love with it and are tremendously excited to support its mission with this gift."

The organization's Palliative Care staff found the Circle of Life site visit invigorating and enjoyable.  The Circle of Life Award presented to our program at the AHA-Health Forum Summit was a great honor.