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Taking Palliative Care Upstream: Lessons from Qualitative Interviews

Taking Palliative Care Upstream: Lessons from Qualitative Interviews. Kerry Case, MD Wheaton Franciscan Healthcare. WI CCCP staff goals: understand challenges + opportunities faced by PC providers how CCCP can support PC efforts improve dialogue around PC issues

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Taking Palliative Care Upstream: Lessons from Qualitative Interviews

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  1. Taking Palliative Care Upstream:Lessons from Qualitative Interviews Kerry Case, MD Wheaton Franciscan Healthcare

  2. WI CCCP staff goals: understand challenges + opportunities faced by PC providers how CCCP can support PC efforts improve dialogue around PC issues (the brainchild, and labor, of Jeanne Strickland)

  3. Interview Process • One-to-one • In person or by phone • July to September 2012

  4. Interviewees • Volunteers from PC chapter/interest group • Roles included • Hospice administrators • Nurse navigators • Hospice nurses • Social workers • PC physicians • Oncologists • 16 interviews conducted

  5. Topics Addressed • Key PC breakthroughs in past few years? • Populations without PC access? • Challenges to delivery of PC to cancer pts? • Role CCCP should play? • Who is missing from conversation? • What other questions should be asked?

  6. Key Recent Breakthroughs? • Increased awareness re: PC • Specialty designation • Integration into treatment • Data re value of PC

  7. Populations without PC Access? • Rural • Tribal • Homeless • Disabled; mentally ill • Young adults • Patients

  8. Challenges in Provision to Cancer Pts? • Association of PC with EOL • Focus on cure/improvement despite late stage • Referrers’ fear that pts will lose hope • Lack of time in pt’s clinic/hospital stay • Lack of trust amongst providers • Fear of ‘leading’ pts to PC

  9. Opportunities to Serve Cancer Pts? • Potential to reframe “hope” • Cancer trajectory predictability • Disease process can anchor discussions • Oncologists can be trained in GOC • Criteria to trigger referral/standardize referrals

  10. Role for WI CCCP? • Statewide community to address training, advocacy issues • Education re resources already available • Forums to discuss and standardize practices • Sample system policies for PC as std of care • Promote “there is not one way to deliver PC” • Encourage ongoing research • Be vocal supporter

  11. Who is Missing? • Underserved populations • PC representative on the WI CCC Steering Committee • ‘team needs to include chaplaincy, social workers, MLP, oncology nurses, cactr admin, pc nurses and grief counselors’

  12. Other Questions? • Continue asking who else should be present • How can HOPE and WI CCCP work together? • What will systems need to incorporate shared-decision making? • How does ACP impact PC? • How can we support PC coverage for outpts? • How will ACA support PC?

  13. Summary • Definition and integration of PC • Need for education • Policy and advocacy support by cancer council

  14. Kerry Case kcase915@gmail.com Jeanne Strickland jsstrickland@uwcarbone.wisc.edu

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