Recruiting an Interdisciplinary Team
Seriously ill patients and their families need a team of skilled professionals.
Because the needs of seriously ill patients and their families are typically complex and multidimensional, a palliative care program requires an interdisciplinary team of professionals. Skills include medical evaluation and decision-making, pain and symptom management, professional to patient and family communications, an ability to address difficult decisions about the goals of care, sophisticated discharge planning and an ability to deliver continuity and reliable access. Equally important is the team's ability to work well and communicate effectively with other health professionals. The respect and positive regard of colleagues on the hospital staff are prerequisite to a successful palliative care program.
For consultation and/or for staffing of a dedicated inpatient unit, the core interdisciplinary team typically consists of a physician, nurse and social worker. In addition, the ideal interdisciplinary team includes dedicated staff time from a bereavement or pastoral care counselor. Fiscal constraints may prevent the program from hiring its own social work and bereavement staff. Alternatively, social service and bereavement staff support may be available through a shared arrangement with the hospital social work and pastoral care departments.
The interdisciplinary team should have special training and/or work experience in palliative medicine and in hospice or nursing home settings, as well as familiarity with the demands and standards of the acute hospital culture. Team clinicians will become the professional representatives both of palliative care as a general discipline and of the hospital's palliative care program in particular. They will provide assessment and care to patients and families and handle professional-to-professional communications - both inside and outside the hospital - that are vital to a successful program.
Other interdisciplinary palliative care staff who provide important clinical and support services to the core staff, patients and families include patient advocates, anesthesia pain experts, rehabilitation (physical and occupational) therapists and psychiatry consultants. Again, depending upon available resources, full-time dedicated staff from these areas may not be possible, but shared arrangements with the "home" departments for these services are an acceptable and commonly used alternative.
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Identifying Stakeholders (session 1 worksheet 2)
Creating an array that broadly identifies people who may be stakeholders is an important step in developing a program design, an approval strategy, and an implementation strategy. The above sheets focus on a “first cut” to help identify players.
Drafting your “dream teams” (session 1 worksheet 3)
Planning for Structure: Committees and Workgroups. This 3 page form builds upon the Identifying Stakeholders worksheet by asking the user to identify appropriate people for a Steering Committee, a Design Workgroup and a Proposed Team.
Changing Physician Behavior -Grand Rounds
Andrew Epstein, MD, partner, and Mark Wenneker, MD, MPH, Senior Consultant, discusses changing physician behavior about palliative care. The audio file is available for download.
Impact of Palliative Care Education on Students
Pull Up Three Chairs: Teaching Palliative Care at Mount Sinai School of Medicine, NY
This video download shows physicians, physicians-in-training and nurse practitioners discussing their rotation in palliative care.
Education and Training as Catalysts to Forming a Palliative Care Service
A CAPC Fall Forum 2001 Workshop
October 2001, Chicago, IL
Broaching the Topic of Palliative Care Consultation with Patients and Families
Last Acts Diversity and End-of-Life Care Literature Review
CAPC State Palliative Care Networks
Palliative Care Consultation Sample Eligibility Criteria
JCAHO Education Event: Essential Elements of Effective Pain Management
This one day educational event provides you and your colleagues with all the information you will need to implement the new Joint Commission pain management standards. This program is offered many times throughout the year at varied locations.
Staffing a Palliative Care Service
Recruiting an Interdisciplinary Care Team
A CAPC Fall Forum 2000 Workshop
Personnel Performance Evaluation:
Standards for all professionals who provide End Of Life Care