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Minnesota Rural Palliative Care Initiative

This page contains materials for participants in the Minnesota Rural Palliative Care Initiative and links to other resources that may be useful to anyone interested in palliative care.

Resources exclusively for initiative participants > Password required to view this content.

General Resources

Action Plan Use. A grid to outline the goals and objectives of your palliative care project. (1-page Word doc)

Case studies of palliative care programs. Materials presented by the Red Wing and Wadena community palliative care teams at Hospice Minnesota's April 2009 End-of-Life Conference, where each community shared its story about their palliative care journey.

  • Fairview Red Wing. Presentation handout describing Red Wing's palliative care program. (4-page PDF)
  • Wadena PowerPoint . Presentation handout describing Wadena's palliative care program. (2-page PDF)
  • Wadena marketing flyer. A consumer flyer that describes Wadena's palliative care program. (1-page PDF)

Center to Advance Palliative Care tools The Center to Advance Palliative Care has assembled a collection of tools to assist in designing, strengthening, maintaining and defending Palliative Care programs. Tools include policies, guidelines, sample documentation forms, measurement and marketing tools.

Communication Challenges at the End of Life. This article discusses communication skills and outlines how to share "bad news."

Long Term Care, Ontario Long Term Care Association, posted with permission. (4-page PDF)

Difficult Discussions Preparing to have a conversation with patients and family members about end-of-life care, presented by Lores Vlaminck, RN, BSN, MA,CHPN. (58-minute audio file. 4/28/09) Handout (14-page PDF)

Handbook for Rural Health Care Ethics—A Practical Guide for Professionals. The handbook uses a case-based approach to analyzing, solving and anticipating health care ethics dilemmas. It is authored by physicians, nurses, health-care ethicists, and hospital administrators who all had scholarship or expertise in rural ethics. Funded by a grant from the National Institutes of Health National Library of Medicine. Download the complete handbook (388-page PDF) or any of the 17 chapters.

Health Care Home Certification - Minnesota Rural Palliative Care Collaborative Crosswalk. This tool outlines the health care homes standards against the work done by communities in the Initiative. (1-page PDF)

Information about Palliative Care Consultation. Provides an outline of what a palliative care consultation addresses and gives an example of a palliative care case. (1-page Word doc)

Non-hospice palliative care case example. Use these tools from Fairview Health Services to assess your patients for palliative care needs:

  • Screening tool Gives three methods to identify patients appropriate for palliative care. (1-page Word doc)
  • Social work assessment Use as part of the palliative care consult, covers levels of cognitive and emotional functioning, patient/family coping and communication skills, family support system, and psychosocial assessment. (2-page Word doc)
  • Spiritual assessment Includes six components of a spiritual care assessment for palliative care patients and examples of questions to begin a dialogue about the patient's spirituality. (1-page Word doc)

Pain Management Strategies for pain management, presented by Dr. Barry Baines, MD, chief medical officer, UCare. (60-minute audio file. 4/16/09) Handout (16-page PDF)

Palliative Care Order Set. Sample palliative care order set provided by Fairview.

Palliative Care Order Set. Sample palliative care order set provided by the Institute for Clinical Systems Improvement.

Quality Care During Advanced Illness: What Do Patients Want That Works? Patients and families often find themselves at odds with or abandoned by their medical providers at at the end of their lives, forced to seek others who will respect their wishes. This podcast features Diane Meier, Director, Center to Advance Palliative Care; Jim Conway, Senior Vice President, Institute for Healthcare Improvement. Produced by IHI. (podcast and resources, October 8, 2009)

Quality Collaborative to Improve Palliative Care Summary. Focused areas of improvement from teams in other collaboratives.

Resources for Clinical Education on Palliative Care. Links to audio conferences, CDs, tip sheets, teaching sheets, self study, and more.

Sample Action Plan. This example can help you understand how to complete your action plan. (3-page Word doc)

Starting a Rural Palliative Care Program: A case example. Kathryn Borgenicht, MD, medical director at Bozeman Deaconess, shares the community's experience starting a program. (40-minute audio file. 2/17/09) Handout (6-page PDF)

Useful Links

Stratis Health recommends the following resources to assist providers in developing and enhancing palliative care programs.

End of Life/Palliative Education Resource Center - Fast Facts and Concepts. EPERC shares educational resource material among the community of health professional educators involved in palliative care education. Its series of fact sheets provide concise, practical, peer-reviewed, and evidence-based summaries on key topics important to clinicians and trainees caring for patients facing life-limiting illnesses. Fast Facts are designed to be easily accessible and clinically relevant monographs on palliative care topics. They are designed to be quick teaching tools for bedside rounds, as well as self-study material for health care professional trainees and clinicians who work with patients with life-limiting illnesses.

Impact Calculator helps estimate how a palliative care program can provide financial savings for your institution. You can use the information generated by the calculator to build administrative support for your program. Center to Advance Palliative Care.

Palliative Care Guideline. This guideline will assist primary and specialty care providers in identifying and caring for adult patients with a potentially life-limiting, life-threatening or chronic, progressive illness who may benefit from palliative care. It outlines key considerations for creating a plan of care to meet patient, family and other caregivers' needs throughout the continuum of care. Institute for Clinical Systems Improvement (ICSI)

Palliative Care Leadership Center. Fairview Health Services' Transitions and Life Choices Palliative Care Program is designated as one of six national Palliative Care Leadership Centers (PCLCs) by the Center to Advance Palliative Care (CAPC) and the Robert Wood Johnson Foundation. These programs host site visits, including training and technical assistance for hospitals and other institutions seeking to start or strengthen their own palliative care programs.

National Healthcare Decisions Day. This annual grassroots effort promotes advance care planning and health care decision making. All Americans are encouraged to voice their wishes and take steps to ensure that their choices are known and protected. April 16 is the day marked for awareness raising and call to action.

National Quality Forum has established a set of 38 best practices for improving palliative care programs outlined in A National Framework and Preferred Practices for Palliative and Hospice Care Quality. Executive summary

Health care organizations that provide palliative care should offer the following services:

  • Comprehensive, 24-hour availability of palliative care through an interdisciplinary team of trained and certified palliative care professionals.
  • Timely communication of patients' goals and care plans in transfers between health care settings.
  • Assessments of patients' pain, anxiety and other symptoms that respect their cultural and individual preferences.
  • Social and spiritual care plans for patients.
  • Continuing professional education and support for caregivers on topics such as symptom management and communication.

Setting or Profession Specific

Hospital

Building a Hospital-Based Palliative Care Program provides guidelines that assist palliative care proponents with establishing successful, lasting programs in their own institutions. It covers making the case for a hospital-based programs, as well as how to design, finance, implement, and measure the program. Center to Advance Palliative Care.

Nurses

E-Learning Management System offers online educational programs for nurses. The course "Opioids in Palliative Care" is currently posted available. It starts with an historical perspective of opioid use and includes pharmacology, equianalgesic conversions, and the peak effect and duration of various drugs. CEU credits available. Hospice and Palliative Nurses Association.

End-of-Life Nursing Education Consortium (ELNEC) is an American Nurses Association project is a national education initiative to

improve end-of-life care in the United States.

Hospice and Palliative Nurses Association is an organization for individual members of the nursing team working in the specialty of hospice and palliative care across the life. The site lists curriculum and other resources specific to advanced nurses, generalist nurses, licensed practical/vocational nurses, and nursing assistants.

Physicians

Education in Palliative and End-of-Life Care (EPEC) is an online program designed to train physicians on the essential clinical competencies required to provide quality end-of-life care. A handbook and video version of the training are both available, as well as slide sets on many palliative care topics. Continuing Medical Education (CME) available.

End-of-Life Curriculum This 16-hour Web-based curriculum incorporates basic material designed for use by physicians in any area of expertise. Developed by the Stanford Faculty Development Center, this eight-module curriculum is implemented as a PowerPoint slide presentation, with slides and teachers' notes on both the content and teaching process. The modules are:

  1. Overview: Death and Dying in the USA
  2. Pain Management
  3. Communicating with Patients and Families
  4. Making Difficult Decisions
  5. Non-Pain Symptom Management
  6. Venues and Systems of Care
  7. Psychiatric Issues and Spirituality
  8. Instituting Change


A variation on this curriculum, designed for the US Veterans Administration, includes short videos, as well as pre- and post-tests.

Hospice and Palliative Care Training for Physicians. This book series is a valuable reference for clinicians who care for patients with serious, life-limiting illnesses. The topics for the nine volumes are:

  1. Hospice and Palliative Medicine Approach to Life-Limiting Illness
  2. Alleviating Psychological and Spiritual Pain in Patients with Life-Limiting Illness
  3. Assessment and Treatment of Physical Pain Associated with Life-Limiting Illness
  4. Management of Selected Non-Pain Symptoms of Life-Limiting Illness
  5. Communication and the Hospice and Palliative Medicine Physician's Role on the Interdisciplinary Team
  6. Ethical and Legal Dimensions of Treating Life-Limiting Illness
  7. Hospice and Palliative Medicine Approach to Caring for Patients with HIV/AIDS
  8. Hospice and Palliative Medicine Approach to Caring for Pediatric Patients
  9. Hospice and Palliative Medicine Approach to Selected Chronic Illnesses: Dementia, COPD, and CHF

Patients and Their Families

End of Life: Helping With Comfort and Care This National Institute on Aging booklet was created to help people make sound health care decisions and get the care they would want for themselves or their family members. Available online or order up to 10 free hard copies via the Institutes' Web site or by call 800-222-2225. (68-page PDF)

GetPalliativeCare.org provides clear, comprehensive palliative care information for people coping with serious, complex illness. Key components of the site include a Palliative Care Directory of Hospitals, a definition of palliative care, and a detailed description of what palliative care is and how it is different from hospice. It also provides an interactive questionnaire to assist people in determining whether palliative care is appropriate for them or their loved-ones. Provided by the Center to Advance Palliative Care.

Palliative Care: The Relief You Need When You’re Experiencing the Symptoms of Serious Illness. This brochure explores palliative care's many benefits and answers common questions. It explains how palliative care aims to ease distressing symptoms, such as pain, breathing difficulties, sleep problems and nausea, when you have a serious illness. You can receive palliative care at the same time you're receiving treatments for your primary illness. Palliative care may significantly improve quality of life for patients with chronic as well as terminal conditions. To receive a free copy by mail, or to order brochures, email or call National Institute of Health, National Institute of Nursing Research at 301-496-0207. (16-page PDF)

www.PalliativeDoctors.org is a consumer Web site that explains the specialty of hospice and palliative medicine and its benefits to patients and families. Developed by American Academy of Hospice and Palliative Medicine, the Web site:

  • Highlights palliative medicine and its broader role in helping patients with all types of serious illness
  • Provides information on how to find a hospice and palliative medicine specialist
  • Includes links to various hospice and palliative care resources and related sites

Training and Events

Expedition: Managing Advanced Disease and Palliative Care

April 14 through July 21, 2010

The Institute for Healthcare Improvement, in collaboration with the Center to Advance Palliative Care, is offering a Web-based program to teach organizations how to improve communication skills concerning decisions to start or withdraw specific life-sustaining treatments. It includes a series of eight Web-based sessions, offered twice a month from April 14 through July 21, 2010. More >

Hospice and Palliative Nurses Association (HPNA) Clinical Practice Forum - Breathing Easier: Palliative Care and Advanced Pulmonary Disease

September 17-19, Bloomington, MN

Pulmonary disease is one of the top four leading causes of death in America. Life-limiting illnesses, such as advanced pulmonary disease present their own unique challenges for patients living with and dying from advanced pulmonary disease. The 2010 Hospice and Palliative Nurses Association Clinical Practice Forum will demonstrate the integration of palliative care and pulmonary nursing practices for end-of-life care management. More >

Online Trainings

Initiative Resources Learning Session #2. Recorded presentations (3/10/09)

Palliative Care Minnesota Rural Initiative - What’s next? Presented by Lyn Ceronsky GNP-BC, CHPCA, Director, Palliative Care, Fairview Health Services. (23-minute Webinar) Handout (6-page PDF, 17 slides)

Model for Improvement. Presented by Karla Weng, Stratis Health. (16-minute Webinar) Handout (8-page PDF, 23 slides)

  • Action Plan Use. A grid to outline the goals and objectives of your palliative care project. (1-page Word doc)
  • Sample Action Plan. This example can help you understand how to complete your action plan. (3-page Word doc)

Palliative Care Insurance Coverage in Minnesota: One Provider’s Experience. Presented by Sandy Schellinger, NP-C, Allina Palliative Care Director. (15-minute Webinar)

Other handouts

 

Palliative Care Web Page