Caring for the seriously ill: developing an inpatient palliative care program at a community hospital

Palliative care is an approach that improves the quality of life for patients and families coping with serious illness at any age and any stage of illness. Through the identification, assessment, and treatment of physical, psychosocial, and spiritual symptoms, palliative care aims to prevent and relieve suffering. The purpose of this paper is to propose a plan for the implementation of an inpatient palliative care program at a community hospital where no formal palliative care services exist. The need for formal palliative care services at this hospital was established and a literature review was undertaken to examine what is known about inpatient palliative care models. Existing research shows that palliative care positively impacts patients, their families, professional providers, and hospitals. An inpatient palliative care consultation service provided by an interdisciplinary team was determined to be the most appropriate model for this hospital. Spradley’s theoretical change model was used as a framework to formulate a process by which an inpatient palliative care consultation service could be implemented. This process identified outcome measurements to determine the program’s impact on patients, their family, the staff providing care, and the fiscal goals of the organization. Specific tools to measure clinical, customer, operational, and financial outcomes were evaluated and recommendations are given.