Abstract
The Department of Pain Medicine and Palliative Care (DPMPC) at the Beth Israel Medical Center developed the Palliative Care for Advanced Disease (PCAD) pathway to guide the interdisciplinary management of imminently dying patients in that hospital setting. Marilyn Bookbinder, Ph.D., R.N., an expert in quality improvement and evidence-based practice, had previously designed similar pathways to improve pain management and to improve the screening for fatigue assessment when she joined this project.1,2 In this interview conducted by Innovations Associate Editor Anna L. Romer, Ed.D., Dr. Bookbinder identifies the PCAD as a way to raise the standard of care for these patients using quality improvement (QI). The actual pathway is available in PDF format on the department’s website along with instructions for its use and ancillary tools.a Dr. Bookbinder describes PCAD, its design and evolution, as well as the initial results from the pilot implementation of the pathway in two treatment and three control units.b PCAD is the first such effort of its kind in the United States. The DPMPC is one of three winners of the American Hospital Association’s 2001 Circle of Life Award. This interview is excerpted from the thematic issue, “Institutionalizing Palliative Care,” Volume 3, Number 4, 2001 of the online journal Innovations in End-of-Life Care at ,www. edc.org/lastacts/..
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