Looking at the numbers

Key program components in palliative care

Ten rural Minnesota communities participated in an 18-month learning collaborative, led by Stratis Health, to design a palliative care program model or focus for their communities and receive education to improve skills in palliative care. At the conclusion of the Minnesota Rural Palliative Care Initiative in early 2011, the 10 communities were well on their way to having in place most of the key components of a fully operational palliative care program.

Palliative care is an approach to managing chronic disease or life-limiting illnesses that centers on relieving suffering and improving quality of life for patients and their families.

Of the processes or systems needed to support palliative care, goals-of-care discussions are the heart of palliative care. Having a process in place to promote these discussions is essential for patients and their families to be able to meet with their care providers to establish the patients' individual goals, such as being well enough to walk to the mail box or spend time with their children. This shared decision making process leads to a care plan based on a patient's wishes regarding quality of life and clarifies whether or not to pursue the most aggressive treatment possible.

Palliative care is supported by advance directives and consistent clinical order sets, such as orders for constipation management/bowel care if opioids are prescribed. Communities participating in the initiative worked to standardize advance directive forms across settings of care.

The general population often has no knowledge about palliative care. Many health care professionals have limited knowledge as well. Education for the community and health care professionals is essential to build support for and use of a palliative care program.

Six of the 10 communities participating in the initiative were providing palliative care services when the initiative concluded in early 2011. The other four were focusing their efforts on standing orders, advanced care planning, and education to health care professionals and the community—all components that build a foundation for palliative care services.

Stratis Health is working to establish or strengthen palliative care programs in rural communities. We assist with building skills and developing processes to improve care planning, symptom management, communication, coordination, and delivery of care to improve the quality of life. Across Minnesota, 16 rural communities have successfully advanced their palliative care offerings by participating in these initiatives. From January 2012 through spring 2014, Stratis Health will be working with an additional six to eight rural communities.

The Minnesota Rural Palliative Care Initiative report (June 2011) is available online. Stratis Health lead this palliative care project with financial support from UCare.

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