Published on September 1, 2017

Alive was approached by TriStar Summit Medical Center two years ago to explore whether we would be interested in providing an inpatient palliative care consult service to their patients. The Alive Palliative Medicine service was implemented in the Tristar Summit Hospital in May 2016 and will be starting at TriStar Centennial Medical Center in September.

Palliative care is a relatively new specialty service now offered in most hospitals in the United States. It makes sense that Alive would be approached to provide this level of expertise because hospice care includes the use of palliative care offered to patients with a life-limiting illness and their decision to forego further attempts at curative treatment. Palliative care is the specialized medical care involving management of pain and other symptoms of a patient’s illness to prevent and relieve suffering during the entire course of the disease process.

Alive Palliative Medicine clinicians always advocate for the patient and their expressed goals of care. It’s what we do.

Palliative medicine is used in patients at all stages of an illness, not just at the end of life. Our physicians and nurse practitioners are specifically trained in the specialties of hospice and palliative medicine and are ideally suited to meet the needs of the hospitalized patients with significant pain and other symptoms. Many of these patients suffer from several serious chronic illnesses that result in re-admissions to the hospital, often for additional symptom management.

Patients referred for palliative care consultation may be identified by hospital care managers because of recurring hospitalizations, ongoing pain or other symptoms that have not responded to usual therapy, increased frailty as the illness progresses or recurrence of cancer with a new burden of symptoms (either from the cancer or its treatments). An order is written for an Alive Palliative Medicine consult and our nurse practitioner assesses the patient for their specific needs. Palliative care management begins with the patient’s expressed goals of care and the symptoms identified by the team.

Some of the symptoms will require medications, but other non-pharmacologic approaches to symptom management are also considered. In some cases, the patient may be approaching the late stages of the illness for which hospice care might be an option. The palliative care consultant will then notify the hospital care manager to determine whether a referral will be made to hospice and which hospice the patient chooses. In our early experience, fewer than half of patients transition to hospice care which reflects the goal of managing these patients’ symptoms earlier in the course of their illness.

Our clinicians are trained to have difficult conversations with patients and their loved ones about decisions that they can make about their ongoing care. These conversations may be the critical part of establishing the right treatment for the right patient at the right time in the right location. Our team works closely with the hospital care managers to make appropriate transitions of care post-hospitalizations with coordination of care among all providers. The Alive Palliative Medicine service has seen a significant increase in the number of patients since its implementation at Tristar Summit Hospital and is recognized as a valuable member of the hospital team caring for these patients.

Patient-centered care is at the heart of palliative and hospice medicine. Patients are not only the focus of the treatments, but must have the greater voice in determining the course of their treatment, sometimes even electing not to undergo recommended treatments. Alive Palliative Medicine clinicians always advocate for the patient and their expressed goals of care. It’s what we do.

For more information about Alive Palliative Care, contact Dr. Robert Berkompas at 615.346.8540 or rberkompas@alivehospice.org.

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