Institutional Palliative Care Clinical Programs

HARBORVIEW MEDICAL CENTER PALLIATIVE CARE CONSULTATION

 

About Palliative Care

Palliative care is specialized medical care for people with serious illness. The main focus of palliative care is to improve the quality of life for patients and their families.  Palliative care is a team approach provided by doctors, nurses, social workers and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.   A visit from palliative care often involves learning who each patient is as a person, understanding their goals and values to develop a personalized plan of care, assisting with medical decision making, providing pain and symptom relief, and offering spiritual, cultural and emotional support.

 

History and Mission

The Inpatient Palliative and Supportive Care Consultation Team at Harborview Medical Center was founded in 2004 with a grant from the Robert Wood Johnson Foundation to Dr. Randall Curtis and the service was built and developed by Dr. Darrell Owens.  Our team, along with the dedicated staff at Harborview, shares a mission to provide the best care possible to all our patients and their families, especially the most vulnerable individuals in our community.  Additionally, since Harborview is the only level 1 trauma and burn center for the state of Washington and a leader in neurosurgery, stroke care, orthopedics, vascular surgery, and HIV care, our team has special expertise in supporting patients and families facing these illnesses.

 

Services

Our team is available 24 hours a day, 7 days a week.  We generally see patients in person Monday through Friday between 8:00am and 6:00pm.  However we are available after hours and on weekends via phone, or in person if needed, for urgent situations or complex symptom management. Our services include, but are not limited to:

  • Helping patients and families live the best life possible
  • Connecting patients and families to information and resources
  • Controlling pain and other symptoms of serious illness
  • Building memories and legacies for patients and their families
  • Providing emotional, social, spiritual, and cultural support
  • Creating a plan of care that is personalized to the patient’s goals, values and preferences
  • Enhancing communication and coordination between the patient, family and care providers
  • Advance care planning and completion of advance directives
  • Grief and bereavement support
  • Coordinating smooth transitions when patients leave the hospital

 

Team

In addition to the team members listed below, we work closely with our colleagues in the Harborview Outpatient Palliative and Supportive Care Clinic.  We also collaborate regularly with the spiritual care department and our team will soon be joined by a dedicated social worker.

  • Tonda Anderson, PA-C
  • Annie Hirano, MD
  • Caroline Hurd, MD
  • Dan Lam, MD
  • Jane Becker, MD
  • Lee Burnside, MD
  • J. Randall Curtis, MD, MPH
  • Catherine Hough, MD, MSC
  • Margaret Isaac, MD
  • Erin Kross, MD
  • Susan Merel, MD
  • Wayne McCormick, MD, MPH
  • Elizabeth Zickler, Administrative Assistant

 

Contact Information

For urgent concerns:

Contact the on-call provider through the Harborview paging operator at 206-744-3000

 

For non-urgent concerns:

Elizabeth Zickler

Program Administrator

Harborview Medical Center

Palliative and Supportive Care Services

206.744.9102

eazickle@u.washington.edu

 

HARBORVIEW MEDICAL CENTER OUTPATIENT PALLIATIVE AND SUPPORTIVE CARE CLINIC

About Palliative Care

Palliative care is specialized medical care for people with serious illness. The main focus of palliative care is to improve the quality of life for patients and their families.  Palliative care is a team approach provided by doctors, nurses, social workers and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.    A visit from palliative care often involves learning each patient’s story, understanding their goals and values to develop a personalized plan of care, assisting with medical decision making, providing pain and symptom relief, and offering spiritual, cultural and emotional support.

 

History and Mission

The Harborview Medical Center Outpatient Palliative and Supportive Care Clinic was founded in 2006 by Dr. Darrell Owens.  Our team, along with the dedicated staff at Harborview Medical Center, shares a mission to provide the best care possible to all our patients and their families, especially the most vulnerable individuals in our community.  Additionally, since Harborview is the only level 1 trauma and burn center for the state of Washington and a leader in neurosurgery, stroke care, orthopedics, vascular surgery and HIV, our team has special expertise in supporting patients and families facing these illnesses.

 

Services

Our team is available 24 hours a day, 7 days a week.  We generally see patients in person 5 days per week, Monday through Friday, either in the clinic or in the patient’s place of residence—personal place of residence, an adult family home, or in a skilled nursing facility. For those who are marginally housed or homeless, we are also able to make arrangements to visit in the various shelters and clinics in downtown Seattle.

  • Helping patients and families live the best life possible
  • Connecting patients and families to information and resources
  • Controlling pain and other symptoms of serious illness
  • Building memories and legacies for patients and their families
  • Providing emotional, social, spiritual, and cultural support
  • Creating a plan of care that is personalized to the patient’s goals, values and preferences
  • Enhancing communication and coordination between the patient, family and care providers
  • Advance care planning counseling and completion of advance directives
  • Grief and bereavement support
  • Coordinating smooth transitions

 

In addition to providing consultative outpatient palliative care, our clinic also provides concurrent primary care for those with a prognosis of less than one year.

 

Team

In addition to the team members listed below, we work closely with our colleagues in the Harborview Inpatient Palliative and Supportive Care Service should any of our clinic patients be admitted, or for hospitalized patients seen by our Inpatient team who would benefit from outpatient follow-up.

  • Jane Becker, MD
  • Erin Kovalenko, Program Coordinator
  • Daniel Lam, MD
  • Martina Martin, ARNP
  • Paula Tichenor, Program Manager
  • Patty Ousley, RN

 

Contact Information

For urgent concerns:

Contact the on-call provider through the Harborview paging operator at 206.744.3000.

 

For non-urgent concerns:

Erin Kovalenko

Program Coordinator

Harborview Medical Center

Outpatient Palliative and Supportive Care Service

206.744.7086

erink@u.washington.edu

 

 

Click on video below to view: "Outpatient Palliative Care from UW Medicine"

 

 

Palliative care and appointment information

 

NW HOSPITAL AND MEDICAL CENTER INPATIENT PALLIATIVE CARE CONSULTATION SERVICES

Northwest Hospital & Medical Center launched its Inpatient Palliative Care Consultation service in February 2013. The Palliative and Supportive Care Service at Northwest Hospital provides palliative care consultation services to patients and families seven days per week, in addition to providing care for patients requiring inpatient hospice care. The service focuses on enhancing quality of life for patient and family, optimizing function, helping with decision-making and providing opportunities for personal growth. It is delivered concurrently with life-prolonging care or as the main focus of care.

 

 About Palliative Care
Palliative care is both a philosophy of care and an organized, highly structured system for delivering care. The Palliative Care Service is a specialty service dedicated to improving the quality of life and easing the suffering of patients, families and caregivers coping with serious illness. Palliative care offers personalized medical care, with special attention to the relief of symptoms, pain, and stress associated with a serious illness. Palliative care is appropriate, whatever the diagnosis, at any age, and at any stage of illness. And, it can be provided together with curative treatment.

 

Our Services:

  • The Palliative Care Service can help patients, families, and caregivers:
  • Live the best possible life
  • Connect to information and resources
  • Manage feelings that come with serious illness
  • Create stability when many different medical teams are involved with a patient’s care
  • Talk about complex medical issues and make important decisions
  • Match healthcare goals to medical treatments
  • Control pain and other symptoms
  • Make end-of-life decisions
  • Help build memories and legacies for your family
  • Navigate the grief process

 

A member of our palliative care team is available to meet with you to develop a comprehensive treatment plan that addresses your needs and what is important to you.

 

Our Team:

Our palliative care team of doctors, nurses, social workers, chaplains and other specialists, work closely with your other doctors, to address the physical symptoms, practical aspects of daily living, and emotional, social and spiritual needs that may arise during serious illness.

 

The Inpatient Palliative Care Team at Northwest Hospital includes:

  • Katie Poinier, BSN
  • Darrell Owens, DNP
  • James Gordon, MD
  • Megan Morrison, ARNP
  • Katie Russell, ARNP

 

Please call 206.368.6850 or email kpoinier@nwhsea.org for more information about our services at NWHMC.

 

SEATTLE CANCER CARE ALLIANCE (SCCA) SUPPORTIVE AND PALLIATIVE CARE SERVICE

 

Seattle Cancer Care Alliance (SCCA) is a world-class, NCI-designated comprehensive cancer center that unites doctors from Fred Hutch, UW Medicine, and Seattle Children’s.

 

SCCA’s purpose is to provide state-of-the-art, patient and family centered care; support the conduct of cancer clinical research and education; enhance access to improved cancer interventions; and advance the standard of cancer care regionally and beyond.

 

For more information about SCCA, please visit our website: http://www.seattlecca.org

 

 

 

What Is Palliative Care?

Palliative care is specialized medicine for people who have a life-limiting or life-threatening

condition. It is an extra layer of support for those with a serious illness, not just for those who

are dying. At SCCA, palliative care is for anyone with a cancer diagnosis, and it’s provided in

conjunction with your regular oncology appointments.

 

Palliative care is all about enhancing your quality of life, including:

• Relieving pain and other symptoms

• Helping you cope with the stress of having cancer

• Helping you understand your condition and your choices for care so you can make decisions that

   are right for you

• Talking with your family about your illness, your treatment, and your wishes

• Determining what is most important to you

• Preparing for the future

• Helping you complete an advance directive for health care, living will, and durable power of

   attorney for health care

• Helping you decide if and when it is right to enroll in hospice

 

If you are an SCCA patient, the team from our Supportive and Palliative Care Service can help improve

your ability to tolerate treatment and carry on with everyday life.

 

Available to Anyone with Cancer at Any Time

Palliative care is available to anyone with cancer regardless of the stage of their disease, the amount of time since their diagnosis, or the type of treatment they are receiving for their cancer. You can receive supportive and palliative care along with treatment to fight your cancer. The Supportive and Palliative Care team works with your oncology team at SCCA to provide in-depth symptom  management and support. Your oncologist continues to make decisions with you about your care.

 

Who is on Our Team?

Clinical Team:

Molly Bumpus, MS, ARNP, ACHPN

Meagan Blazey, MS, ARNP

Charlie Pieterick, MS, ARNP, ACHPN

Jodie David, RN, CCRC

Judy Fihn, RN, CHPN

 

In addition, we utilize social workers, chaplains, the cancer pain clinic, psychiatrists, psychologists, child life specialists, physical therapists, nutritionists, and patient educators as needed.

 

Leadership Team:
   Elizabeth Trice Loggers, MD, PhD.
   Medical Director, SCCA Palliative Care; Assistant Member, Fred Hutch

   Moreen Dudley, MBA, MSW, LICSW.
   Administrative Director, SCCA Palliative Care;
   Director, Supportive Service, Radiation Therapy and Specialty Clinics

   Petr Horak, Program Coordinator

 

Proven Power of Palliative Care

The American Society of Clinical Oncology recommends that palliative care be integrated into standard

oncology care for patients with advanced cancer or significant symptoms at the time of their cancer

diagnosis. This recommendation comes from a randomized controlled study that showed improved survival  in patients with newly diagnosed metastatic non-small cell lung cancer who received early palliative care along with standard oncologic treatment.1 These patients also had better quality of life and less depression. That’s why at SCCA, if you have advanced cancer or significant symptoms at diagnosis, we want to talk with you about integrating palliative care into your treatment.

 

Palliative Care Is Not the Same as Hospice Care

Hospice care is designed for people who are in the last six months of their life and who are not receiving treatment aimed at curing their disease or prolonging their life. Usually hospice care is provided in your home by your own caregiver (such as a family member) along with a hospice team (specialized nurses, social workers, chaplains, and volunteers) that visits regularly.

 

The Supportive and Palliative Care team can help you decide if and when it is right to enroll in hospice. We can also assist with referrals to hospice care and provide ongoing coordination of care with the hospice team, if and when this is appropriate.

 

Learn More or Make an Appointment

To find out more about SCCA’s Supportive and Palliative Care Service, ask your SCCA doctor,

 

 

To make an appointment, call the scheduler at (206) 288-7324, Monday through Friday, 8 a.m. to 5 p.m.

appointment with our service.

SEATTLE CHILDRENS PEDIATRIC ADVANCED CARE TEAM (PACT)

The Pediatric Advanced Care Team (PACT) at Seattle Children’s is committed to improving the quality of life for all children with potentially life limiting illnesses and their families by reducing suffering, maintaining hope and promoting healing. We seek to prevent and relieve suffering with the highest quality pain and symptom management to protect all aspects of personhood that may be threatened by disease.

 

We work to promote patients’ and families’ hopes as they progress through the journey of their illness with an informed willingness to enter into the experience with our patients and families. We support families in their journey to find meaning in their child’s illness by offering our services in an unconditional manner with no temporal limits.

 

PACT has established a secure role at Seattle Children’s, with 15 years of service, a mature record of research and generous support from the community.

 

PACT consists of 6 providers:

  • Ross Hays, MD
  • Michelle Frost, RN -  Nurse Manager
  • Julie Arguez, MSW
  • Mark Power, BCC
  • Steve Poole, MDiv
  • Lauren Leyser, CCLS

 

The Service provides inpatient consultation for an average of 120 new referrals per year, constituting over 3000 discreet patient encounters.

 

 The use of triggered, automatic consultations for stem cell transplant, ECMO and brain stem

tumors has established early intervention with palliative care as a standard for the most high-risk populations.

 

The decision-making tool (DMT) developed at SCH has now been adopted for use at 21 other pediatric palliative care programs nationwide.

 

The unique transdisciplinary service model employed by PACT maximizes the team’s ability to serve a relatively large caseload over a long period of time (mean visits/case =22) with a minimum

of staff.

 

PACT is a charter member of PPCRN the Pediatric Palliative Care Research Network, a collaborative, multi-center investigational group. PACT enjoys a close working relationship with

the community-based, dedicated pediatric hospice and palliative care program at Providence Hospice of Seattle.

UNIVERSITY OF WASHINGTON MEDICAL CENTER PALLIATIVE CARE SERVICES

The University of Washington Medical Center Palliative Care Consultation Service began in 2005 when UWMC invested a 0.5 FTE physician in a consult based Palliative Care Service (PCS) to support primary medical teams in the care of seriously ill patients and their families.

 

The PCS has been  extremely successful.  It  expanded in 2009 from 1.5 FTE to 4.25 FTE with the goal of moving from a consult based service toward an integrated hospital system of care making Palliative Care a standard of care received by all complex, high case mix index patients from the first days of hospitalization.

 

The Joint Commission, a national nonprofit aimed at improving public health through evaluation and accreditation of  exceptional health services, has awarded UW Medical Center certification for their Advanced Palliative Care Program.  UW Medical Center is the only hospital in Washington state to have received certification in palliative care and one of only  56 certified hospitals in the United States. The Joint Commission began certification for palliative care in September  2011 to recognize “hospital inpatient programs that demonstrate exceptional patient and family-centered care and optimize the quality of life for patients (both adult and pediatric) with serious illness.”

 

We have been moving toward a system based model, which will become the standard of care.  In 2009 we provided consults to 345 unique patients and in 2011 we consulted 658 unique patients and their families that generated a total of 780 new consults.

 

Our partners in all the adult ICUs, Regional Heart Center, Solid Organ Transplant, Surgery, and Oncology are clear that they want to be national leaders in the continued expansion of Palliative Care as part of the standard of care we provide all seriously ill patients and their families.

 

The UWMC Palliative Care Consultation Service plans to expand over the next few years based on the innovative opportunities UWMC has to offer and hopes to build on its demonstrated success.  Such an expansion will allow UWMC to become a national leader among Academic Medical Centers in Palliative Care.

 

The faculty represents all major teaching sites and primary disciplines of palliative medicine within the UW School of Medicine.  Core and affiliated UW faculty provide training in clinical care, research, and leadership, in keeping with all ACGME core competencies.

 

Clinical rotations include inpatient consult services, inpatient palliative care units, affiliated long term care facilities, home-based palliative care experiences including hospice care, and ambulatory outpatient clinics. Elective rotations include geriatrics, oncology, nephrology, pulmonary / ICU, interventional pain management, interventional radiology, radiation oncology, dementia units, and AIDS/HIV care settings.

 

The fellowship provides a mentored training experience to develop fellows' clinical skills, ensure core competency development as educators and program administrators, provide exposure to research and quality improvement, thereby fostering the development of future leaders in palliative care medicine.

 

The program includes comprehensive evaluation of individual fellows, faculty, and the training program. Each UW-affiliated institution has made major commitments to build and sustain an outstanding environment for palliative care practice and training.

 

Palliative care and appointment information

 

VETERANS AFFAIRS PUGET SOUND HEALTH SERVICES

The VA Puget Sound Health Care System (VAPSHCS) is a two-Division facility with campuses in Seattle and at American Lake near Tacoma.

 

The VAPSHCS Palliative Care and Hospice Service (PCHS), in existence since 2001 with teams at both Divisions since 2010, provides a full range of consultative services addressing the patient’s physical, psychological, social, and spiritual needs.

 

The PCHS advises the primary care team or provider on symptom management, goal setting, discussion of code status, communication issues, decision-making, management of spiritual and existential distress, disposition issues, management of psychosocial issues, and care in the last hours of life.  The PCHS provides information and emotional support to patients and their families, assesses patients’ appropriateness for and interest in hospice care, and facilitates discharge planning and referrals to community hospice programs (over 400 referrals for hospice care in the community are made each fiscal year).  Additionally, team members communicate regularly with community hospices as case managers for hospice patients receiving home care.

 

The PCHS performed over 580 consultations in Fiscal Year 2014.  Over a third of VA ICU patients who die receive palliative care consultation, and in Fiscal Year 2014, 81% of all inpatient deaths at VA Puget Sound Health Care System were seen by the PCHS in the year prior to death.  In 2014, 43% of Veterans seen by PCHS had a cancer diagnosis, with the remainder having various diagnoses including end-stage cardiac, pulmonary, and renal disease; dementia; amyotrophic lateral sclerosis, and stroke.   After the death of an inpatient Veteran at VA Puget Sound, bereaved family members are contacted between 1 and 3 months after the Veteran’s death to complete a voluntary 20 question survey regarding the quality of care provided in the facility prior to the Veteran’s death.  The results of the Bereaved Family Survey for our facility are compared with data from other VA facilities throughout the nation.  In the first 3 quarters of Fiscal Year 2014, 60% of family members contacted rated the overall care their loved one received as “excellent”.

 

The PCHS team includes physicians, palliative care and hospice nurses, palliative and hospice care coordinator, social workers, psychologist, chaplain, and administrative support personnel.  Other professionals including pharmacists, psychiatrists, dietitians, physical therapist, occupational and recreation therapist are available by consultation.  The interdisciplinary PCHS team meets weekly to review all active patients on the service, as well as to debrief regarding patients who have recently died.  A Memorial Service for families of Veterans who have died is held semi-annually, and contact is made with bereaved family members via bereavement cards and telephone calls.

 

When hospitalization for end of life care is required, patients are admitted to hospice beds in the VA Puget Sound Health Care System’s Community Living Center (CLC) at either the Seattle or American Lake Division, or to community nursing homes with hospice support provided by community-based hospice agencies.  The Seattle Division CLC is a 38 bed residential skilled nursing care setting within the acute care hospital.  The Seattle CLC blends multiple missions including comprehensive geriatric evaluation and management, sub-acute rehabilitation, respite, and end-of-life care in a seamless continuum of care.  The Seattle CLC has a Hospice Service staffed by the PCHS, which provides care for up to 10 Veterans receiving inpatient end of life care. Many of these patients require aggressive symptom management.  The American Lake Division CLC is an 83 bed residential skilled nursing facility with a focus on long term care and dementia care, and with up to 6 beds for palliative care and 6 beds for hospice care.

 

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