Circles of Influence 2011

Organization: The Center for Hospice & Palliative Care, Cheektowaga, NY. Innovation highlights were its broad range of service, strategic approach to understanding and meeting community needs and collaboration across the health care continuum.

Recent Achievements: The Center for Hospice & Palliative Care (CHPC) was honored with the Circle of Life Award in 2011. CHPC is still dedicated to the provision of palliative care, both within and outside the Medicare Hospice Benefit, and now serves as many palliative care patients as it does hospice patients (approximately 900 total patients per day).

Since the NYS Palliative Care Information Act went into effect in 2011 mandating that clinicians offer terminally-ill patients information and counseling concerning palliative care and end-of-life options, CHPC has become more invested in providing palliative care upstream of the Hospice Medicare Benefit.

While our hospice census is rather stable, our palliative care census continues to grow. Our home-based palliative care service, Home Connections, is one of the more mature home-based palliative care programs outside of a vertical health system. Our palliative care service has some unique elements including payer support and pediatric service. In addition to home-based and pediatric palliative care we also offer hospital palliative care consults.

CHPC has also had experience with a Medicaid palliative care model through NY State's DSRIP initiative, a program designed to cut Medicaid costs by 25% while improving care. Our current DSRIP census is 100 adult and 20 pediatric patients. Additionally, we are collaborating with two licensed hospice programs in Niagara and Chautauqua counties to fulfill DSRIP’s palliative care mandates in those counties.

In an exciting new development, the CHPC IT department is currently testing using an algorithm as an overlay to a primary care giver’s EMR as a way to help community physicians identify patients who may be appropriate for Home Connections. This algorithm is based on metrics that include disease burden, ER visits and/or hospitalization frequency, etc. The objective is to prompt physicians to realize that a particular patient might be a good candidate for palliative care and prompt a referral to Home Connections. This tool allows earlier identification of those in need of palliative care by providing real time data to the practice group.

The Palliative Care Institute research team continues to provide insight into issues affecting how we provide hospice and palliative care. Recent publications include:

• Rachel M. Depner, Pei C. Grant, David J. Byrwa, Jennifer M. Breier, Jennifer, Lodi-Smith, Christopher W. Kerr & Debra L. Luczkiewicz (2016): A consensual qualitative research analysis of the experience of inmate hospice caregivers: Posttraumatic growth while incarcerated, Death Studies, DOI: 10.1080/07481187.2016.1237591.
• Scott T. Wright, Jennifer M. Breier, Rachel M. Depner, Pei C. Grant & Jennifer Lodi-Smith (2017): Wisdom at the end of life: Hospice patients’ reflections on the meaning of life and death, Counselling Psychology Quarterly, DOI: 10.1080/09515070.2016.1274253.
• David J Byrwa, Rachel M Depner, Pei C Grant, Christopher W Kerr, Debra L Luczkiewicz, Kathryn Levy (2017): End-of-Life Dreams and Visions: The capacity for growth and meaning, poster presentation
• Kelly E. Tenzek and Rachel Depner (2017): Still Searching: A meta-synthesis of a good death from the bereaved family member perspective, Behavioral Sciences.

Hospice Buffalo received the 2017 Hospice Honors Elite Award from Deyta Analytics, a division of HEALTHCAREfirst. This program recognizes hospices providing the highest level of quality as measured from the caregiver’s point of view. This honor was given to only 75 out of 1,600 participating hospices.

Organization: Gilchrist Hospice Care, Hunt Valley, MD. Innovation highlights were its communication and coordination across settings, integration of palliative and geriatric care, and staff education, orientation and mentoring. 

Recent Achievements:  GHC continues to look for new and innovative programs and offerings to expand the scope and breadth of both hospice and palliative care throughout our community.  Since our last “Circles of Influence” update in 2012, GHC has instituted a “We Honor Vets” program, in conjunction with NHPCO, to ensure that the contributions of terminally-ill veterans are recognized and acknowledged and their special needs met and added a Music Therapy Program to complement the offerings of our other clinical disciplines. GHC has been approved as a Music Therapy intern training site by the American Music Therapy Association. 

Gilchrist Services, of which GHC is a part, launched Gilchrist Transitions, a non-medical program designed to address the needs of patients who fall “in between” the services through the end-of-life continuum but desperately need extra care and support. This program primarily serves patients discharged from hospice because their health has stabilized or individuals who have reached out to the GHC team but were either determined not yet to be terminally-ill or not yet ready to accept hospice. Transitions offers case management and extra support in the home from volunteers. 

GHC and its partner in Tanzania, Nkoaranga Lutheran Hospital’s Palliative Care Program, were selected as the 2014 recipients of the Foundation for Hospices in Sub-Saharan Africa (FHSSA) Global Partnership Award. This award recognizes the “exemplary work of one partnership that has demonstrated leadership, innovation and has significantly contributed to the sustainable development of hospice and palliative care through their FHSSA partnership.” 

2014 also marked GHC’s 20th Anniversary of providing the finest in end-of-life care for terminally-ill patients in Central Maryland and care and support for their loved ones. 

Award Impact:  Receiving the Circle of Life Award remains one of GHC’s most visible and valued awards which recognized and validated the organization’s many contributions in the field of hospice, palliative and geriatric care. It helped GHC strengthen its quality and safety initiatives and helped to nurture a culture which emphasized patient-centered care leading to quality outcomes.

Organization:  St. John Providence Health System, Detroit, MI. Innovation highlights were its culture change in the organization, education to spread primary palliative care, and attention to spirituality and engagement with the faith community.