UCHealth is in the process of expanding its palliative care program in northern Colorado to include outpatient services.
“It’s what is best for the patient,” said Joann Lovins, senior director of UCHealth oncology in northern Colorado, who is spearheading the new program.
But to explain why it’s best for the patient, one must first understand what palliative care is and is not.
“The biggest misconception is that palliative care is the same as hospice care,” said Dr. Joe Lopez, UCHealth’s medical director of Palliative Care at Poudre Valley Hospital and Medical Center of the Rockies.
While hospice care is an end-of-life service, usually provided in the last six months and when curable treatments are no longer being considered, palliative care is best started before a person’s chronic illness even lands him or her in the hospital, Lopez said.
But whether inpatient or outpatient palliative care is used, the service is there to help patients and their families — at any stage of a serious illness — identify goals of care and goal-aligning treatments. A palliative care expert helps in the decision-making process, addresses pain management and symptom control — whether spiritual, emotional or physical — all while the patient, no matter the age, continues to seek disease-focused treatment options. The service works alongside primary treating services to provide an extra layer of support to improve the quality of life for both patients and their families.
Studies show that patients who utilize palliative care have fewer emergency room visits and fewer days in the hospital and skilled nursing facilities, said Jean Kutner, MD, MSPH, chief medical officer and palliative medicine physician at UCHealth’s University of Colorado Hospital in Aurora.
“Palliative care improves quality of life, and recent data has also shown that it can improve longevity for patients with severe, chronic illness,” said Dr. Matthew Sorensen, oncologist with UCHealth Cancer Center in Fort Collins. “Our core purpose as medical providers is to provide patients with both of these things in balance, depending on the clinical scenario.
“Palliative care provides a very important extra layer of care for these patients who deal with symptoms from both their underlying disease and the treatments that are given to control the disease.”
So how do palliative care teams work to complement other physicians’ services?
Whereas physicians’ primary training is in diagnosing and treating diseases, palliative care teams are made up of physicians and nurse practitioners who are specially trained and board certified in areas such as pain and symptom management, communicating outcomes and creating achievable goals for care.
“Palliative care is a proactive stance,” Sorensen said. “Much of medical care provided today is reactive in nature. When palliative care is on board for my patients early, I know that they are more likely to be successful with treatment because their symptoms are better controlled, and controlled earlier in their journey.”
UCHealth’s new program is considering a model that would further train medical professionals in palliative care, as well as provide a team of palliative care specialists for consultations and to address more demanding or complicated cases, Lovins said.
PVH and MCR have provided hospital-based palliative care services for more than three years, and Lovins said it’s a common practice to wait until a strong inpatient program is in place before expanding to outpatients. She said that now is that time as UCHealth has a strong and collaborative program along Colorado’s Front Range.
UCH implemented the first inpatient palliative care program in Colorado and added an outpatient clinic last July. UCHealth’s palliative care programs have grown stronger because of these experiences, Kutner said.
“We work closely together throughout the [UCHealth] system and developed systemwide goals within palliative care,” she said. “It’s all about the patient and making sure we are giving them the best care possible.”
Currently, Lovins and the palliative care work group are conducting a needs assessment to determine how their outpatient service could best serve the northern Colorado population. The assessment entails surveying key stakeholders, including clinical leaders and providers, support services, patients and their caregivers.
The program will pilot within UCHealth’s northern Colorado Cancer Center and oncology clinics. After a trial period of several months, Lovins said she hopes the new program will roll out into other areas, such as cardiovascular, pulmonary and neurology.
“There is this sensitivity about palliative care,” Lovins said. “We need to get the message out that it’s not about giving up; it’s a supportive piece to treatment that can help improve quality of life and survival, as well as reduce health care costs.”