Leslie Conner, CHC, Compliance Specialist, Housecall Providers, OR
Case focus
The November Project ECHO session focuses on the challenges of caring through crisis while supporting patients, families, and staff through a natural disaster.
Elena Sherr, MSW, APHSW, Hospice Manager at Horizon Home Care and Hospice, PCNOW Secretary, WI
Subject Matter Experts
Faith Protsman, MD, HMDC, Regional Medical Director for California, Vitas Healthcare, CA
Tomasina Chamberlain, MSN, MBA, RN, CHPCA, Director of Compliance, Delaware Hospice, DE
Josh Bassarear, LCSW, ACHP-SW, Social Work and Bereavement Team Lead, Circle of Life, AR
Case focus
October’s Project ECHO session focuses on the heart wrenching case of an elderly caregiver experiencing fatigue and suicidal ideation, while caring for a spouse with slow and terminal decline from Alzheimer’s Disease. Hospice and palliative care providers are often faced with navigating challenging situations involving caregiver burnout and patient safety. The session explores the ethical challenges involved in ensuring patient and caregiver safety while navigating complex family dynamics and preserving goal concordant care
Jennifer Hale, MSN, RN, CHPN, VP, Quality and Standards, Compassus, TN
Subject Matter Experts
Victoria Snyder, RPh, VP of Provider Services Harry Hynes Memorial Hospice, KS
Mary Alfano-Torres, MD, FAAHPM, HMDC, Senior Medical Director, AccentCare Hospice and Palliative Care of Maryland, MD
Sarah Simmons, RN, MSN, CHPN, Director, Quality, National Hospice and Palliative Care Organization, VA
Case focus
The session focuses on medication reconciliation practices and their significance in providing safe, high-quality care to hospice and palliative patients. Despite this, many providers lack an accurate, standardized medication reconciliation process leading to unnecessary hospitalizations, increased cost burdens, and patient safety issues. This session offers a systemwide approach to refining medication reconciliation that helps improve outcomes for patients and the healthcare system.
Uzma Khan, MD, Medical Director for Hospice and Palliative Medicine Jefferson Hospital, Allegheny Health Network, PA
Georgina Lorenzi, RN, Care Coordinator, Palliative Medicine Jefferson Hospital, Allegheny Health Network, PA
Subject Matter Experts
Andy Arwari, MD, MS FACP SFHM FAAHPM HMDC, Hospice Palliative Care Educator, Holistic Patient-Centered Care Advocate, Medical Director for Miami, Vitas, FL
Sara Dado, LCSW , Executive Director- Adult Palliative Programs, The HAP Foundation, IL
Amy Rose Taylor, AGNP-BC, DNP, MSN, BSN, RN, FIEL Chief of Staff to CEO, Dr. George Rapier WellMed Medical Management NY
Kimberly Spering, MSN, CRNP, FNP-B.C., ACHPN, OACIS/Palliative Medicine Nurse Practitioner, Lehigh Valley Health Network, PA
Case focus
This month’s case study focuses on the role of palliative care in managing the serious illness and quality of life across the continuum of care. There is an increasing number of older patients in need of palliative care services. Despite the presence of palliative care in most larger city hospitals, there remains a gap in filling this need and also being curious of how to improve health care. Timely identification of the disease process, patient-centered discussions regarding prognosis, and effective goals of care conversations play a decisive role in creating a seamless transition from serious illness to palliative and supportive care, and eventually, to high-quality end-of-life care.
This session focuses on the unique but direct relationship between a strong workflow process and quality measure outcomes like Length of Stay (LOS) in hospice care. Discussion revolves around important questions like – Does it matter at when the face-to-face interaction happens? What are the factors that impact LOS? How can I make sustainable and long-term improvements involving the full interdisciplinary team? Hear about one provider organization’s successful journey in improving timely face-to-face encounters and LOS in hospice patients.
This month’s case study is related to the implications and assessment areas to consider in the care of an older adult experiencing end stage Alzheimer’s dementia. Most importantly, the session discussion is focused around the role of the IHI 4M framework in differentiating the person’s journey through the dementia process and aligning their care plan to the right resources at the right time in the right setting, across the continuum of hospice and palliative care and end of life support.
Kamal Wahab, MD, Family and Geriatric Medicine Specialist, Palliative Medicine consultant North Florida Regional Medical Center, Associate Medical Director, Vitas, Florida
Paul Longnecker, RN, MBA, PhD Senior Instructor, Graduate Faculty MS in Allied Health Program, Otterbein, University, Westerville, OH
Fran Klouse, RN, St. Croix hospice, MN
Case focus
This month’s case study is related to physical and social complications secondary to CVA event. Discussion revolves around patient and family struggling with dysphagia, protein calorie malnutrition and physical disabilities. Issues involved are at the intersection of patient choice versus perceived cognitive ability to make choice for self and role of POA. There is an ethics element to this case study as well.
AccentCare Hospice & Palliative Care of CT, CT: Jessica Sturgeon, MT-BC, HPMT, Music Therapist
Subject Matter Experts
Steven Smith, MD, FAAP, Medical Director Home Based Palliative Care and Hospice, Nationwide Children’s Hospital, OH
Jennifer Palmer, MSN, RN, CHPPN, Pediatric Team Leader, Hospice Of The Western Reserve, Inc, OH
Maggie Scheppmann, MM, MT-BS, Music Therapist, Bluegrass Care Navigators, KY
Braedyn Inmon, MT-BC, Music Therapist, Vitas, CT
Case focus
Music Therapy is often an under-utilized and misrepresented clinical tool in hospice and palliative care. However, Music Therapy can be a valuable tool within the interdisciplinary group construct to promote wellness, cohesiveness, and continuity of care. Further, Music Therapy can promote communication between the family and interdisciplinary team that allows for more inclusive and effective hospice care plan. Often the voices of children get lost in the medical paradigm due to several factors that could include age, fear of discussing “the hard stuff”, and bias. This can the impede the work that can be done within the family system and with the hospice interdisciplinary team itself.
Case Presenters – Transitions LifeCare, Raleigh, NC
Sara Sousa, RN, BSN, MPH, CCM, Performance Improvement Coordinator
Betsy Barton, MPH, CT, Senior Associate for Learning and Research
Martha Vet, RN, Palliative Care Nurse Navigator
Leslie Sutton, MD, Hospice and Palliative Medicine Physician
Subject Matter Experts
Halley Harris, LAICSW, Hospice of Northwest, WA
Paul Longnecker, RN, MBA, PhD Senior Instructor, Graduate Faculty MS in Allied Health Program, Otterbein University, Westerville, OH
Debra Vermette, MD, Hospice and Palliative Medicine Board Certified, Vitas, Philadelphia, St. Mary’s Medical Center in-patient Palliative Care Program, PA
Case focus
Role of Ethics Committee in Voluntarily Stopping of Eating and Drinking (VSED) Policy and Education
Eric Bush, MD, Chief Medical Officer, Hospice of the Chesapeake and Chesapeake Supportive Care, MD
Deena H. Cress, MSW, APHSW-C, CCISM, Director of Psychosocial Services and We Honor Veteran Program, LHC Group-Hospice Division, VA
Anton Lukevic, M.A., R.R.T- Vitas HealthCare Tinley Park, IL
Case focus
This month’s case involves a 74-year-old female patient with COPD and a history of mental illness and opioid use disorder. Patient was previously with agency, but revoked hospice benefit when undergoing surgery for femur fracture. Though staff had assessed safety concerns during the first admission, she was readmitted given she met eligibility requirements. Patient continued to have unmanaged pain, SOB, anxiety, and other symptoms of mental illness, such as erratic mood swings and aggressive behaviors.
Didactic Presentation slides – Link currently unavailable
Duke University and Palliative Care Quality Collaborative
Arif Kamal, MD, MBA, MHS Physician Quality and Outcomes Officer, Duke Cancer Institute Associate Professor of Medicine Division of Medical Oncology and Duke Palliative Care
Jon Nicolla, MBA Executive Director – Palliative Care Quality Collaborative President – Prepped Health LLC
Case focus
BiteSizeQI, a task-oriented web-based application to learn quality improvement skills for professionals – “Top 10 tips” for conducting impactful QI project.
