Palliative Case Management—Alpha to Omega (507)

Abstract

1.Describe how case management and palliative care share many principles and key elements.2.Discuss how this palliative care case management program was developed and the successes measured.3.Identify elements from this program that could be applicable to a program within their areas of practice. Successful case management programs share many key elements with palliative care programs. Learning from their successes in the managed care environment and extensive evaluation across the spectrum of disease can be helpful for palliative care programs, particularly as they move upstream to patients at the time of diagnosis and follow patients throughout the continuum of care. This session will describe how successful case management principles can help develop palliative care programs, how palliative care can be integrated into case management programs for various diseases, and how palliative care can be evaluated within managed care organization data, through the experience of a long-standing, successful cancer palliative care case management program, Omega Life. The session will describe key attributes of successful case management, including identifying individuals with specific conditions or needs in a timely manner; assessment and care planning; implementing services through relationships with providers, families, and insurance, education, and coordinating care; and reassessments and accessibility. We will discuss the Omega Life palliative care cancer case management program, with its services to help both patient and family with issues of disease education, communication, care coordination, symptom management, benefits education, care planning and advance directives, and hospice and bereavement where needed and wanted. Finally, we will describe how the service was evaluated through case studies and administrative and clinical data, by evaluating hospitalizations and hospice use. In a comparison of 69 patients who enrolled in the program for at least 1 week, compared to 20 patients who did not enroll and who died by the end of the study period, 59% of patients had no hospitalizations compared to 15% in the control group (P=.006) and 83% enrolled in hospice, compared to 55% in the control group (P=.01). Structure and Processes of Care