Expanding Palliative Care Accessibility: Models for Palliative Care delivery in Primary Care and Hospital-Based Settings (TH369)

Abstract

•Compare and contrast primary palliative care and consult based care delivery.•Describe interdisciplinary peer education strategies.•Describe longitudinal support system from academic center to rural community hospital to improve palliative care access for patients in rural communities.•Evaluate successes and barriers in supporting palliative care planning and implementation in rural ICU setting. Primary palliative care is a model to deliver palliative care that can be used by treatment teams without access to full palliative care consult teams. This includes primary care offices which are the center of care for many patients with serious illness, especially those in rural and underserved regions. Ensuring excellent palliative care delivery within these models is critical to improving quality of care across the trajectory of serious illness. Primary palliative care benefits patients and families by decreasing symptom burden, suffering, conflict and non-beneficial treatments while increasing quality of life, comprehension and satisfaction. It similarly benefits clinicians and health systems by decreasing conflict, costs, length of stay and delivery of non-beneficial therapies. Primary palliative care can use triggers, guidelines and decision support tools to aid primary providers in palliative interventions and communication. This is increasingly recognized in value-based payment models such as Accountable Care Organizations (ACOs) and the Comprehensive Primary Care Plus program, thus creating an opportunity for palliative care clinicians. This concurrent session will present unique, multidisciplinary approaches to enhance primary palliative care delivery. These models vary from providing training for hospital-based and primary care clinicians to integrating palliative specialists in primary care. They include:1.Focused geriatrics and palliative care skills training for primary care physicians within an ACO.2.A trial of home-based palliative care embedded within a primary care practice vs. usual office-based care enriched with palliative care training for primary care clinicians.3.A systematic intervention to improve serious illness communication in primary care.4.A curriculum on best practice approaches to delivering primary palliative care for hospital-based teams with community education and outreach. Both primary care and palliative care needs and resources vary widely by region and practice. Each model presented will emphasize the process of needs assessment and stakeholder engagement preceding program design and implementation. This will equip attendees to return to their own communities and begin to engage with primary care practices around developing models of care.