PCCE NEWSLETTER A Message from the Director October 2014 As we approach the end of our second successful year, the Palliative Care Center of Excellence is planning a very busy and exciting Fall/Winter season. One of the highlights is the development and piloting of the UW Palliative Care Training Center (PCTC). Led by Dr. Stu Farber and Coordinated by Drs. Larry Mauskch and Ardith Doorebos, the PCTC is in the final stages of developing its curriculum and plans to begin its pilot 13 month training program in March 2015. The PCTC is generously supported by a grant from the Cambia Health Foundation. Watch for announcements about registration including links to a new webpage for more details! Another highlight is the vast array of visiting lecturers that are planning to visit and interact with our leaders and our membership. Dr. Diane Meier, Director of the Center to Advance Palliative Care at the Mount Sinai Medical Center in New York recently presented for Geriatric Grand Rounds at Harborview Medical Center. We are pleased to announce several more nationally recognized speakers including: 1) Dr. Atul Gawande, Author and Palliative Care Lecturer, October 20th at Seattle Town Hall 2) Dr. Karl Lorenz, UCLA School of Medicine, October 15th for the UW Palliative Care Grand Rounds 3) Dr. Daren Heyland, Queen’s University School of Medicine, October 16th for the Seattle Area Chest Grand Rounds 4) Dr. Graeme Rocker, Dalhousie University, November 25th for the Palliative Care Research Seminar 5) Dr. Jennifer Temel, Harvard Medical School, December 16th for the Palliative Medicine Conference 6) Dr. Steve Pantilat, UCSF School of Medicine, for the Annual HMC Palliative Care Conference in April 2015 I would also like to congratulate Drs. Caroline Hurd, Claire Creutzfeldt and Lynn Reinke on being recipients of the Cambia Health Foundation Sojourn Scholar Leadership Award. We are very proud and excited to have 3 of the 10 awards recipients as faculty of the University of Washington and members of the PCCE. www.uwpalliativecarecenter.com New sletter Spotlight Special Event Notice UW Palliative Care Grand Rounds “Measuring the Quality of Palliative Care: Challenges and Opportunities” Karl A. Lorenz, MD MSHS Director, VA National Hospice and Palliative Care Program Quality Improvement Resource Center Associate Professor, Geffen/ UCLA School of Medicine Wednesday, October 15th 8:30am-9:30am Harborview Medical Center Maleng Building Room 111/112 As you can see, we have a lot to be excited about! Be watching *Supported by a grand from the for more details and announcements as each lecture approaches. Cambia Health Foundation We look forward to your interest and involvement in our programs! As always, thank you for your support and interest in the Palliative Care Center of Excellence. We welcome your feedback and look forward to your participation in the ongoing implementation of our Center and in providing excellent care to all patients with serious illness and their families. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine Three me mbers of the PCCE aw arded Cambia Health Foundation Sojourn Scholars Aw ards on October 2nd On October 2nd, Drs. Caroline Hurd, Claire Creutzfeldt and Lynn Reinke were named recipients of the Cambia Health Foundation Sojourn Scholar Leadership Award. This inaugural class of awardees included 10 accomplished researchers, clinicians and educators from across the UW pursuing excellence in palliative care. Each will receive a $180,000 grant to pursue projects in their field. Cambia Health Foundation began its Sojourns Awards program in 2010 to shine a light on regional palliative care leaders, sharing their innovations and investing in their future work. Prior award winners include Drs. Randy Curtis, Tony Back and Darrell Owens. The Foundation has built on the success of the Sojourns Awards to create the Sojourns Scholar Leadership Program. This new, national initiative is focused on cultivating emerging palliative care leaders that will drive innovation throughout the field and the healthcare system. Dr. Caroline Hurd focuses on training medical professionals in palliative care communication at the University of Washington, Dr. Claire Creutzfeldt works in palliative care for stroke patients at the University of Washington, and Lynn Reinke works on palliative care for multi-morbidity patients at the VA Puget Sound. The Leadership of the PCCE would like to offer them congratulations on their awards. Pictured below are Lynn Reinke, Caroline Hurd and Claire Creutzfeld with Mark Ganz, President and CEO of Cambia Health Solutions. Dr. Caroline Hurd featured in a KOMO New s story Terminal Cancer Patient is ‘Teaching All of Us’ Click on the link below to see the KOMO News story of Frank Henderson, a man diagnosed with terminal cancer who is determined to make the most out of his life. "I think it's powerful and inspirational," said Dr. Caroline Hurd. "I think he's teaching all of us." Dr. Hurd is the Director of the Education Operations of the Palliative Care Center of Excellence http://www.komonews.com/news/local/Doctor-Terminal-cancer-patient-is-teaching-all-of-us277329041.html?tab=video&c=y Onclive.com article features Dr. Anthony Back Dr. Anthony Back, professor (Medical Oncology) was quoted in the feature article “Oncologists Warned – Don’t take Burnout Lightly” in Oncology Business Management, and was identified as one of the most cited authors on doctor burnout. “The bad news is that a serious problem exists. The good news is that we’re finally taking it seriously. We’re doing more research and, perhaps more importantly, we’re finally paying attention to the research and thinking about how to address burnout,” said Anthony L. Back, MD, Co -Director of the Palliative Care Center of Excellence who is one of the most cited authors on doctor burnout. CLICK HERE for the full article. Atul Gaw ande: Dying With Dignity The Palliative Care Center of Excellence is co-sponsoring following community event with the Seattle Town Hall Civics Series: Atul Gawande: Dying with Dignity Monday, October 20th 7:30pm—8:45pm The recent medical disputes around Casey Kasem’s death (Where a judge allowed his daughter to withhold food) have drawn attention to artificially prolonging life, decision-making processes and other death-related issues. In Being Mortal: Medicine and What Matters in the End, Atul Gawande analyzes the process of death, dying, the meaning of care—and how doctors are getting it wrong. According to Gawande, a surgeon at Brigham and Women’s Hospital, despite modern medical advancements, treatment “falls short” when it comes to the elderly and aging. He explores examples of nursing home patients confined to railed beds, the “devastating,” lifeextending procedures used by hospitals, and how these methods can be improved through Hospice and other dignified care methods. Gawande is also the author of Complications and The Checklist Manifesto. Presented by: PCCE and Town Hall and the University Book Store, as part of the Civics series. Series supported by The Boeing Company, the RealNetworks Foundation, and the True-Brown Foundation. Series media sponsorship provided by The Stranger and KUOW. Tickets: $5 Doors open: 6:30pm PCCE Hosts 2nd Annual Community of Educators Retreat 2nd Annual PCCE Community of Educators Retreat When: Thursday, November 13th, 2014, 8:30am-12:30pm Where: Harborview Research & Training Bldg Auditorium Why: Creation of a Core Competency Developmental Blueprint Who: People from all disciplines interested in palliative care education endeavors Keynote Speaker: Anthony Back, MD, Professor of Medicine and Co-Founder of Oncotalk and VITALTalk LAST YEAR: Has gone by fast and though we did not nearly accomplish everything on our list, we do have several highlights: Annual HMC Palliative Care Conference: With the hard work of Kathy Colagrossi and many others, we expanded this popular 1 day conference to a 2 day event including a half day on cutting edge research with our keynote Speaker, Rebecca Sudore, talking about the PREPARE resource for advanced care planning and a half day interactive session on complementary medicine, led by Leila Kozak, Lyn Miletich and Joyce Greenberg. We had over 150 attendees and are planning to expand the conference to a larger venue in 2015! Education Resource Guide: We crowd sourced all of you for your favorite palliative care resources and consolidated these under the education section of the UW PCCE website, which can be found here: http://depts.washington.edu/pallcntr/educational-resources.html Trainee Education: There continues to be development and refinement of a communication training curriculum for high stakes communication that is being piloted in pediatrics and we hope to begin in the internal medicine for the next academic year. THIS YEAR: One of the main priorities voiced at last year’s retreat was the need for a common set of core competencies and best practices for various levels of training (pre-licensure, postlicensure, RN, MD, SW etc.) and various practice settings (inpatient palliative care, outpatient palliative care, primary palliative care etc.). The primary focus of this years’ retreat will be to begin to define and outline this “Developmental Blueprint.” The goal will be to create a shared vision of the critical palliative care competencies at each stage for a healthcare professional and then work together to identify education resources that can be used at each stage. The morning promises to be filled with lively discussion and an opportunity to network with colleagues passionate about this work and we hope you can all join us. Please look for a formal RSVP in coming weeks. Thank you again, Caroline J. Hurd Director of Education Operations University of Washington Palliative Care Center of Excellence Cynthia Doherty inducted into the Nursing Hall of Fame The International Nurse Researcher Hall of Fame honors nurse researchers who are Honor Society of Nursing, Sigma Theta Tau International (STTI) members; who have achieved significant and sustained national and/or international recognition for their work; and whose research has impacted the profession and the people it serves. The Honor Society of Nursing, Sigma Theta Tau International (STTI) inducted 25 nurse researchers into the International Nurse Researcher Hall of Fame at STTI’s 25th International Nursing Research Congress in Hong Kong, 24-28 July 2014. On Saturday, 26 July, these 25 esteemed individuals representing the countries of Australia, Taiwan, United Kingdom, and the United States were presented with the International Nurse Researcher Hall of Fame award; participated in a conversation with STTI President Hester C. Klopper, PhD, MBA, RN, RM, FANSA; and were celebrated for their achievements. PCCE Member Cynthia Dougherty was named one of the 25 honorees. Cynthia M. Dougherty, PhD, ARNP, FAHA, FAAN, is professor in the Department of Biobehavioral Nursing and Health Systems at the University of Washington School of Nursing, USA, and a nurse practitioner in cardiology at the VA Puget Sound Health Care System. Dougherty is a pioneer and remains one of a handful of nurse scientist experts in promoting health for patients and families in the context of cardiac arrest and receipt of the implantable cardioverter defibrillator (ICD). Over the past two decades, she and her research team have engaged in clinical research on behalf of patients who suffer cardiac arrest, are resuscitated by paramedics, and go on to receive an ICD and live normal lives. Visiting Lecturer —Dr. Daren Heyland "The Very Elderly Admitted to ICUs in Canada: A Quality Finish?" Daren Heyland, MD, MSc, FRCPC Professor, Department of Medicine & Critical Care Program, Queens University School of Medicine Director, Clinical Evaluation Research Unit, Kingston General Hospital Thursday, October 16th - Respiratory Critical Care Conference 1:30pm - 2:30pm Harborview Medical Center Research & Training Bldg Rm 109/113 Dr Daren Heyland is a critical care doctor at Kingston General Hospital and a Professor of Medicine and Epidemiology at Queen’s University, Kingston, Ontario Canada. He is trained in Internal Medicine, Critical Care Medicine, and Clinical Epidemiology. He currently serves as the Director of the Clinical Evaluation Research Unit at the Kingston General Hospital which functions as a methods center for multicenter clinical research (See www.ceru.ca). For over a decade, he chaired the Canadian Researchers at the End of Life Network (CARENET, www.thecarenet.ca) which has a focus on developing and evaluating strategies to improve communication and decision-making at the end of life. Overall, Dr. Heyland has published approximately 250 peer-reviewed papers and raised more than $88 million in external grant support. PCCE Members Bibliography *Articles listed are 2014 publications in peer-reviewed journals and book chapters. If you have an article you would like to have featured, please email pallcntr@uw.edu. Aslakson RA, Curtis JR, Nelson JE. The changing role of palliative care in the ICU. Cirt Care Med. 2014 Aug 27. [Epub ahead of print] PMID: 25167087 Brazg, T., Dotolo, D., and Blacksher, E. (2014). Finding a seat at the table for social work: Recommendations for broadening the scope of bioethics. Bioethics. doi: 10.1111/bioe.12106. Carpenter, K. M., Stoner, S. A., Schmitz, K., McGregor, B. A., & Doorenbos, A. Z. (2014). An online stress management workbook for breast cancer. Journal of Behavioral Medicine, 37(3), 458-468. PMCID: PMC3622129 Curtis JR, Barnato AE, Variability in decisions to limit life-sustaining treatments: is it all about the physician? Chest. 2014 Sept 1;146(3):532-4. PMID 25180716 Curtis JR, Rubenfeld GD. “No escalation of treatment” as a routine strategy for decision-making in the ICU: con. Intensive Care Med. 2014 Sep;40(9):1374-6. doi: 10.1007/s00134-014-3421-6. Epub 2014 Aug 5. PMID: 25091792 Doorenbos, A. Z. (2014). Mixed methods in nursing research: Their overview and practical examples. The Japanese Journal of Nursing Research, 47(3), 207-228. Glare, P. A., Davies, P. S., Finlay, E., Gulati, A., Lemanne, D., Moryl, N., ... & Syrjala, K. L. (2014). Pain in cancer survivors. Journal of Clinical Oncology, 32(16), 1739-1747. Gordon, D. B., Loeser, J. D., Tauben, D., Rue, T., Stogicza, A., & Doorenbos, A. Z. (2014). Development of the KnowPain-12 pain management knowledge survey. Clinical Journal of Pain, 30(6), 521-527. PMCID: PMC3989468 Howell AA, Nielsen EL, Turner AM, Curtis JR, Engelberg RA. Clinicians’ perceptions of the usefulness of a communication facilitator in the intensive care unit. Am J Crit Care. 2014 Sep;23 (5):380-6. Khandelwal N, Curtis JR. Economic implications of end-of-life care in the ICU. Curr Opin Crit Care. 2014 Sept 12 [Epub ahead of print] PMID: 25222642 Long AC, Kross EK, Engelberg RA, Downey L, Nielsen EL, Back AL, Curtis JR. Quality of dying in the ICU: Is it worse for patients admitted from the hospital ward compared to those admitted from the emergency department? Intensive Care Med. 2014 Aug 13. [Epub ahead of print] PMID: 25116294 Marchand L. Integrative and complementary therapies for patients with advanced cancer. Ann Palliat Med 2014;3(3):161-171. doi: 10.3978/j.issn.2224-5820.2014.07.01 Merel S, DeMers S, Vig E. Palliative care in advanced dementia. Clin Geriatr Med. 2014 Aug;30(3):469-92. doi: 10.1016/j.cger.2014.04.004. Epub 2014 Jun 12. Oliver DP, Washington K, Kruse RL, Albright DL, Lewis A, Demiris G. Hospice Family Members' Perceptions of and Experiences With End-of-Life Care in the Nursing Home. J Am Med Dir Assoc. 2014 Oct;15(10):744-50. Samata, RV, Bloise R, Davis MP. Efficacy and safety of a six-hour continuous overlap method for converting intravenous to transdermal fentanyl in cancer pain. J Pain Symp Mgmt, 48(1), 132-6. Sprung CL, Truog RD, Curtis JR, Joynt GM, Baras M, Michalsen A, Briegel J, Kesecioglu J, Efferen L, De Robertis E, Bulpa P, Metnitz P, Patil N, Hawryluck L, Manthous C, Moreno R, Leonard S, Hill NS, Wennberg E, McDermid RC, Mikstacki A, Mularski RA, Hartog CS, Avidan A. Seeking Worldwide Professional Consensus on the Principles of End-of-life Care for the Critically Ill: The Welpicus Study. Am J Respir Crit Care Med. 2014 Aug 27. [Epub ahead of print] Tariman, J. D., Doorenbos, A., Schepp, K. G., Singhal, S., Berry, D. L. (2014). Older adults newly diagnosed with symptomatic myeloma and treatment decision making. Oncology Nursing Forum, 41(4), 411-419. Vig EK, Foglia MB. The steak dinner-a professional boundary crossing. J Pain Symptom Manage. 2014 Sep;48(3):483-7. doi: 10.1016/j.jpainsymman.2013.10.011. Epub 2014 Jan 10. Wittenberg-Lyles E, Demiris G, Oliver DP, Burchett M. Exploring aging-related stress among older spousal caregivers. J Gerontol Nurs. 2014 Aug;40(8):13-6. If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER A Message from the Director July 2014 Many exciting things have been happening within the Palliative Care Center of Excellence in the last few months. I’ll summarize some of them in this quarterly message. We are honored to announce that the Department of Family Medicine at the University of Washington Medical Center has launched a fund-raising campaign to develop the Farber Professorship in honor of Dr. Stuart “Stu” J. Farber and his wife, Annalu Farber. Dr. Farber’s leadership as well as his educational and clinical excellence have laid the foundation for much of what we have been able to accomplish with the Palliative Care Center of Excellence. Please review the details in the announcement below for information about making a donation. The entire leadership of the PCCE has committed to donating and I urge you to join us. Our Community Advisory Board has organized quarterly meetings through the end of the year. The goal of the Community Advisory Board is to provide advice, input, and support for the Palliative Care Center of Excellence to help ensure that the Center meets its mission of improving the lives of patients with serious illness and their families. The Community Advisory Board is comprised of volunteer community members who faced serious or terminal illness personally or through a family member or loved one, so that they may bring their perspectives as patients and family members to advise the leaders and members of the Palliative Care Center of Excellence. We are excited to be expanding our portion of the PCCE website and developing our first handbook for members as well and laying plans for several important community activities including the scheduling of The Conversation Project for a Seattle event in the near future. Our next meeting is July 18th at Harborview Medical Center. If you or anyone you know are interested in finding out more or joining the Board, please contact us at pallcntr@uw.edu or 206-7445412. The UW Cambia Palliative Care Training Center planning team is finalizing its curriculum after several months of intense work and has presented its preliminary plans with its Steering Committee. The progress was met with unanimous approval. We look forward to the launch of its pilot training program this Fall. We’ll keep you informed of the Training Center’s progress and when we are ready to begin our first palliative care certification program. www.uwpalliativecarecenter.com New sletter Spotlight UW Medicine Pulse: Palliative Care Podcast Palliative Care is specialized medical care for people with serious, life-shortening illnesses. Its aim is to maintain function and quality of life, relieve pain and other distressing symptoms, while neither hastening nor postponing death. Not postponing death. Therein lies the distinction between palliative care and the traditional medical approach, where typically every effort is made to postpone death, no matter the cost, whether physical, emotional or financial. On this episode of UW Medicine Pulse we meet some remarkable people who have made caring for the seriously and terminally ill their specialty; and who say, though it can be difficult, it is also inspiring and rewarding to help patients plan for the final stages of life. This Spring, UW Medical Center received Joint Commission CLICK HERE to hear or downCertification for its Palliative Care Inpatient Program. The UW load the podcast Palliative Care Clinical Strategic Planning Committee has formed a Joint Commission Certification Working Group. We are moving forward with plans to apply for certification at all of our hospitals including Harborview Medical Center, Valley Medical Center, Northwest Hospital and the Seattle Cancer Care Alliance. Our goal is to achieve certification at all UW Medicine hospitals by 2015. The Cambia Health Foundation has graciously awarded the University of Washington a grant for a project entitled “Implementing and disseminating quality metrics for primary and specialty palliative care in impatient and outpatient settings.” There are more details in the announcement below. We are very excited to begin focusing on palliative care metrics and looking forward to creating a model metrics system that can be disseminated to other healthcare systems. As always, thank you for your support and interest in the Palliative Care Center of Excellence. We welcome your feedback and look forward to your participation in the ongoing development of our Center and in providing excellent care to all patients with serious illness and their families. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine Clinical Update —Northw est Hospital Palliative Care Service On February 11th, 2013 my Northwest Hospital palliative care pager signaled our service’s first inpatient consultation request. To this day, I still remember the patient, his wife, and their story in great detail. This was the first of over 600 consultation requests we have received since then. We have had an incredibly positive response to our service being on The Northwest Hospital & Medical Center campus and have truly enjoyed working with the excellent clinicians here. Our work with patients and families has been rewarding and fulfilling, even through some of the toughest situations. Our four inpatient providers are doing a great job and we are continuing to build a thriving service that collaborates incredibly well with the rest of the inpatient staff to provide the best patient care possible. Our team is still growing and we will welcome another ARNP in the coming months. Early in 2014, the UW Medicine Outpatient Primary, Palliative, and Supportive Care Program expanded its locations and now has an office at NWHMC! Out of this location, the program provides home visits to those in the community for whom it is difficult to get to provider office visits. Our ARNPs see patients in their private homes, assisted living facilities, adult family homes. In addition, Darrell Owens, DNP sees patients in the SCCA clinic here at NWHMC. We continue to use our registered nurse case management model to help manage patients’ symptoms while keeping them in their home environments, prevent emergency department visits, and reduce hospital admissions. Over the past two years, the outpatient program patient census has grown to include people living in Aegis Assisted Living facilities. This has grown into a partnership with these communities, and we have become a preferred provider to the residents of the 14 local facilities. Both UW Medicine and Aegis Living celebrate the tremendous success of the affiliation, and both are committed to meeting the medical needs of frail elders in the communities where they reside. To that end, Aegis Living, through philanthropic giving, and Northwest Hospital through funding and administrative oversight have created a one-year Clinical Nurse Practitioner Fellowship in Geriatrics and Palliative Care. We are absolutely thrilled to announce this new fellowship program. This is the first ARNP fellowship of its kind in the United States, and will be an opportunity to provide an ARNP with specialty education and training. We are very excited and extremely proud to have this partnership, and we look forward to serving more of our elderly population at the Aegis Living communities and in the community at large. Please welcome Julia VanderVegt, DNP to this role and expect to see her at weekly palliative medicine and geriatrics rounds. We look forward to another successful year of inpatient consultations and outpatient service growth, development, and challenge as we continue to touch the lives of those in the community. Katie Poinier, RN, BSN Program Manager Northwest Hospital Palliative Care Service Cambia Health Solutions Announces Industry’s Most Comprehensive Palliative Care Program Cambia Health Solutions is announcing a new palliative care program that takes a groundbreaking approach to serving individuals with serious illness and those who care for them. With the launch of the most comprehensive palliative care program in the nation, Cambia has created a person-focused system by putting the patient’s goals at the center of an interdisciplinary care team that places quality of life as a top priority and includes the patient’s family in the care plan. The new program will be available as early as this summer to the more than 2.2 million members of Cambia’s family of health plan companies in Oregon, Washington, Idaho and Utah. “We’re changing the conversation about serious illness care,” said Mark Ganz, President and CEO of Cambia Health Solutions. “Our program puts our members and their families in charge of their health care, allowing people to live with dignity and a sense of control even when facing a serious illness. At Cambia Health Solutions, we believe that palliative care is deeply personal and fundamentally rooted in respect for a patient’s wishes. Our investments in palliative care are not about a return on investment. This is about a return on humanity.” Please see the complete announcement on the Cambia Health Solutions website here: http://news.cambiahealth.com/news/cambia-health-solutions-announces-industrys-mostcomprehensive-palliative-care-program Funding Opportunity Announcements Funds are available from the Cancer Center Support Grant (CCSG) to support cancer-related pilot projects. This competition will provide four awards of up $80,000 in direct costs plus facilities and administrative costs. This year we are targeting projects addressing Global Health and Health Disparities research in addition to other proposals. Additional information can be found in the RFA. All members of the Cancer Consortium are eligible to apply. Applications are due Friday, August 1 by 5:00 pm. See the link below for details and the RFA: http://www.cancerconsortium.org/en/about/funding-opportunities/pilot-awards.html Jennifer Jacyszyn FHCRC/UW Cancer Consortium 206-667-6250 jblaesin@fhcrc.org Below please find a Funding Opportunity Announcement (FOA) designed to provide mentorship and seed funding for research activities through the Palliative Care Research Cooperative Group (PCRC). This particular FOA encourages small research grant applications focused on supporting investigator development for building the science of palliative care. Funded proposals will use the PCRC infrastructure, may draw upon PCRC generated data, and involve PCRC investigators as mentors. Interest Letters are due July 14, 2014 Applications are due August 1, 2014 The earliest funding start date is October 1, 2014. Re eligibility, please note: At least one of the Principal Investigators must be a PCRC Member or PCRC Junior Investigator Member The Principal Investigator OR at least one member of the applicant team must be a junior investigator The FOA is also available on the PCRC website: www.palliativecareresearch.org For questions about the FOA, please contact: Carey Candrian (carey.candrian@ucdenver.edu) Thank you, Amy, Jean and Christine Amy P. Abernethy, MD PhD, Co-Chair Jean Kutner, MD, MSPH, Co-Chair Christine Ritchie, MD, MSPH, Chair - Scientific Review Committee Executive Committee | The Palliative Care Research Cooperative Group (PCRC) Cambia Health Foundation Aw ards University of Washington Metrics Project Grant The University of Washington has been awarded an $800,000 grant from the Cambia Health Foundation for a project entitled, “Implementing and disseminating quality metrics for primary and specialty palliative care in impatient and outpatient settings.” The purpose of the three-year grant is to develop and implement quality metrics and a dashboard across four diverse hospitals, including numerous and varied inpatient and outpatient programs. This project will create a model and resources for other healthcare systems. Dr. Randy Curtis, Professor of Medicine at the University of Washington School of Medicine and Director of the UW Palliative Care Center of Excellence will serve as the Principal Investigator with Dr. Ruth Engelberg and Dr. Helene Starks as the co-Principal Investigators . PCCE Faculty New s Ardith Doorenbos, PhD RN FAAN, Co-Chair of the Research Operations of the UW Palliative Care Center of Excellence, has been elected to be the leader of the Palliative Care and End-ofLife topic area of the 2014 Oncology Nursing Society Agenda. Dr. Wayne McCormick, Co-Chair of the Clinical Operations of the UW Palliative Care Center of Excellence has been elected Co-Chair of the American Academy of Hospice and Palliative Medicine (AAHPM) Academic Palliative Medicine Committee. AAHPM is the professional organization for physicians specializing in hospice and palliative medicine, nurses, and other healthcare providers. Since 1988, the Academy has dedicated itself to advancing hospice and palliative medicine and improving the care of patients with serious illness. The Academy’s core mission is to expand access of patients and families to high-quality palliative care and advance the discipline of hospice and palliative medicine through professional education and training, development of a specialist workforce, support for clinical practice standards, and research and public policy. The core purpose of the Academy is to improve the care of patients with life-threatening or serious conditions through the advancement of hospice and palliative medicine. Stuart J. Farber, MD and Annalu Farber Endow ed Professorship in Palliative Care Education The Department of Family Medicine at the University of Washington Medical Center has launched a fund-raising campaign to develop the Farber Professorship in honor of Dr. Stuart “Stu” J. Farber and his wife, Annalu Farber. This requires raising $500,000 dollars and the Department of Family Medicine is well on its way with several large gifts. They are now ready to turn to a broader group of clinicians and others that have worked with Dr. Farber or support his work. Stu Farber has in many ways been the founder of clinical palliative care at the University of Washington Medical Center and across the UW system. His leadership as well as his educational and clinical excellence have laid the foundation for much of what we have been able to accomplish with the Palliative Care Center of Excellence and beyond. Importantly, we would like to note that 100% of the leadership of the PCCE has committed to contribute to this important cause. Please join us in creating this Professorship and help to honor the legacy that Stu has worked to create. If you would like to contribute to this effort, or if you would like to learn more about the Stuart J. Farber MD and Annalu Farber Endowed Professorship in Palliative Care Education, please contact Caroline Anderson, Assistant Vice President for advancement, at 206-221-2899 or cmanders@uw.edu. CLICK HERE for more detailed information. Sue Taylor featured in K en Burns’s new Cancer Documentary Dr. Sue Taylor has been featured in Ken Burns' three-part, six-hour documentary based on the Pulitzer Prize-winning book The Emperor of All Maladies: A Biography of Cancer, scheduled to air on PBS next spring. The video interview with Dr. Taylor, an internist from Seattle, is available at the weblink below in which she discusses dealing with her brother’s death from Burkitt lymphoma when he was an adolescent, and reveals toward the end that she is a palliative care physician. During a telephone interview Taylor said that after practicing internal medicine for many years and then getting involved in medical administration, she entered a palliative care fellowship at the University of Washington last year and will soon be moving to Arizona to direct the palliative care program at Tucson Medical Center. She explained that she and Lin MacMaster, who was named Chief Revenue and Marketing Officer of the American Cancer Society last year, had worked together in Seattle several years ago. MacMaster then contacted her about sharing her story in a video related to The Story of Cancer documentary. ACS is one of the outreach partners involved in promoting the film. http://thestoryofcancer.org/ PCCE Members Bibliography *Articles listed are 2014 publications in peer-reviewed journals and book chapters. If you have an article you would like to have featured, please email pallcntr@uw.edu. Artherholt SB, Hong F, Berry DL, Fann JR. Risk factors for depression in patients undergoing hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation 20:9469-950, 2014 Berry DL, Hong F, Halpenny B, Patridge AH, Fann JR, Wolpin S, Lober WB, Bush N, Parvathaneni U, Back A, Antmann D, Ford R. The Electronic Self Report Assessment for Cancer and Self-care Support: results of a multi-center randomized trial. Journal of Clinical Oncology 32:199-205, 2014 Bombardier CH, Fann JR, Wilson CS, Heinemann AW, Richards JS, Warren AM, Brooks L, Warms CA, Temkin NR, Tate DG, for the PRISMS Investigators. A randomized controlled trial of venlafaxine XR for major depressive disorder after spinal cord injury: Methods and lessons learned. Journal of Spinal Cord Medicine 37:247-263, 2014 Bryce TN, Richards JS, Bombardier CH, Dijkers MP, Fann JR, Brooks L, Choido A, Tate D, Forchheimer M. Screening for neuropathic pain after spinal cord injury with the Spinal Cord Injury Pain Instrument (SCIPI): a preliminary validation study. Spinal Cord 52:407-412, 2014 Cuff L, Fann JR, Bombardier CH, Graves DE, Kalpakjian CZ. Depression, pain intensity, and interference in acute spinal cord injury. Topics in Spinal Cord Injury Rehabilitation 20:32-39, 2014 Curtis JR, Sprung CL, Azoulay E. The importance of word choice in the care of critically ill patients and their families. Intensive Care Medicine 2014; 40:606-8. Curtis JR, Levy MM. Our responsibility for training physicians to understand the effect patient death has on them: The role of the intensivist. Chest. 2014 May;145(5):932-4. Kalpakjian CZ, McCullumsmith CB, Fann JR, Richards JS, Stoelb BL, Heinemann AW, Bombardier CH. Post-traumatic growth following spinal cord injury. Journal of Spinal Cord Medicine 37:218-225, 2014 Mackelprang JL, Bombardier CH, Fann JR, Temkin NR, Barber JK, Dikmen SS. Rates and predictors of suicidal ideation during the first year after traumatic brain injury. American Journal of Public Health 104:e100-e107, 2014 Parker Oliver D, Albright DL, Washington K, Wittenberg-Lyles E, Gage A, Mooney M, Demiris G. Hospice caregiver depression: the evidence surrounding the greatest pain of all. J Soc Work End Life Palliat Care. 2013;9(4):256-71. Pirl WF, Fann JR, Greer JA, Braun I, Deshields T, Fulcher C, Harvey E, Holland J, Kennedy V, Lazenby M, Wagner L, Underhill M, Walker DK, Zabora J, Zebrack B, Bardwell WA. Recommendations for the implementation of distress screening programs in cancer centers: report from the American Psychosocial Oncology Society, Association of Oncology Social Work, and Oncology Nursing Society Joint Task Force. Cancer. May 2, 2014 [Epub ahead of print] Williams RT, Wilson CS, Heinemann AW, Lazowski LE, Fann JR, Bombardier CH, PRISMS Investigators. Identifying depression severity risk factors in persons with traumatic spinal cord injury. Rehabilitation Psychology 59:50-56, 2014 Wittenberg-Lyles E, Washington K, Demiris G, Oliver DP, Shaunfield S. Understanding social support burden among family caregivers. Health Commun. 2014;29(9):901-10. If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER A Message from the Director April 2014 With the completion of the first year of the Palliative Care Center of Excellence, this is an ideal opportunity to look back on our accomplishments and to share some exciting news with our members. First, the UW Medical Center has received Joint Commission Advanced Certification in Palliative Care for its Inpatient Palliative Care Service. Founded by Dr. Stu Farber and currently led by Dr. Jacqueline Raetz, the UW Palliative Care team worked tirelessly to achieve this honor and we are proud and grateful for their time and energy. There is more information below. Congratulations to everyone involved! Second is the completion of our first PCCE Annual Report. With the help of our leadership, Jimmy Hoard, our Program Operations Specialist and head of the PCCE Administration Core compiled this report to list in detail the accomplishments of our first full year. Highlights include activities of our Research and Education Operations,the growth of our Clinical Operations as well as accomplishments of our leadership and membership. Check out our Newsletter Spotlight to the right for more information and a link to the full report. We would like to thank everyone who has helped to establish the Palliative Care Center of Excellence. Our goal is to have all UW Medicine hospitals achieve this important step. In our December newsletter, we regretted to announce that Dr. Stu Farber, Director of the UW Palliative Care Service, was diagnosed with Acute Myelogenous Leukemia. It is with a heavy heart that I have to also announce that Dr. Farber’s wife, Lu, has now also been diagnosed with AML. Our thoughts and prayers go out to Stu and his family. To find out more, or to look for ways to support the Farbers, you may visit Stu’s caring bridge website: http://www.caringbridge.org/visit/stuartfarber. www.uwpalliativecarecenter.com New sletter Spotlight PCCE 2013 Annual Report The UW Palliative Care Center of Excellence, launched in October 2012, has already become an international leader in advancing the science and the delivery of palliative and end-of-life care. In its first annual report, the Center cites significant progress in its goals to advance palliative care by increasing interdisciplinary and interprofessional collaborations in clinical care, education and research. “I am extraordinarily pleased with the progress in each of Stu Farber launched the UW Palliative Care Service in 2005 and these areas. Our programs are his remarkable leadership has helped UW Medicine achieve nu- growing rapidly and meeting the high standards that we set,” said merous important accomplishments such as the Joint Commission accreditation and the funding of the Palliative Care Training J. Randall Curtis, the A. Bruce Montgomery, M.D. American Center by the Cambia Health Foundation. Lung Association Endowed Chair in Pulmonary and Critical The leadership of the Palliative Care Center of Excellence is Care Medicineand Director of profoundly grateful for Stu Farber’s accomplishments and we the UW Palliative Care Center will continue to follow his example of excellence in palliative of Excellence. The co-director care medicine at the University of Washington. of the Center is Anthony Back, UW Professor of Medicine in As always, thank you for your support and interest in the Palliathe Division of Medical Oncolotive Care Center of Excellence. We welcome your feedback and gy. look forward to your participation in the ongoing development of our Center and in providing excellent care to all patients with serious illness and their families. CLICK HERE to review the PCCE 2013 Annual Report J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine PCCE Clinical Update: Seattle Cancer Care Alliance Outpatient Palliative Care Consult Service Ever have that feeling that life is moving incredibly fast and yet incredibly slowly at the same time? Our ongoing efforts at Seattle Cancer Care Alliance (SCCA) to build the outpatient palliative program is punctuated by rapid change and slow, persistent administrative effort. After years of dedicated effort to highlight the importance of Palliative Care at SCCA by Moreen Dudley MSW, MBA (Director, Supportive Care and Specialty Clinics) – and myself since 2011 – the Palliative Care service was selected as an SCCA-wide Initiative for 2013-2014. As a result, in the last year we have hired two nurses (Judy Fihn and Anita Chandler) and a new ARNP (Charlie Pieterick) to join Pam Davies, ARNP, as the front line of our clinical service at SCCA. We welcome these new additions and thank Pam for her years of dedicated service!! On the other hand, we continue to search for another ARNP or PA, and likely another nurse over the coming year. We are thrilled to have the resources to meet the known (significant) gap in clinicians to address patient and family needs at SCCA, but like all programs, finding the right person and onboarding is time intensive for all involved. We thank our program administrator, Petr Horak, for his unfailing efforts to make this process as smooth and enjoyable as possible for everyone. Similarly we have been pushing, pushing, pushing to get our screening program off the ground. This is in response to the Commission on Cancer’s mandate to screen all cancer patients for psychosocial distress by 2015, as well as the PCCE’s goal for each palliative care service. Like giving birth to any new “baby”, there is a lot of pushing, a lot of waiting, and a tremendous amount of anticipation as we plan to launch the pilot of web-based screening this month in my own Sarcoma clinic! We also anticipate a lot of process improvement over the next year as this spreads to other clinics and then longitudinally over time. Our goal is multifaceted: 1. Screen patients in a timely fashion, 2. Create automatic consults (as moving efficiently from screening to action is the usual problem for screening programs), 3. Facilitate tracking of consult completion, appropriateness and implications for FTE needs, 4. Ensure the data are available for all clinicians and 5. Support use of the data for research purposes. Fast and slow, we are also creating standardized notes, updating pamphlets and web sites, revising existing institutional policies, developing new policies (and forms) for assigning proxies and creating advance directives and continuing our very successful “Schwartz Rounds” (a multidisciplinary rounds to engender compassion for our work with patients and families). Simultaneously, with the help and support of Stuart Farber and Jackie Raetz, UWMC, and Wayne McCormick, HMC, we are realizing the long-anticipated goal of bring palliative care fellows to SCCA as part of the fellowship experience. Finally we continue to participate in a research pilot of early, outpatient palliative care for transplant patients (Stephanie Lee, PI), which seems to be picking up steam. So with much anticipation, joy, determination -- and an odd sense of whiplash -- we will continue to hurry up and wait, hurry up and wait in the endless pursuit of the perfect outpatient palliative care program at SCCA. Elizabeth Loggers, MD, PhD Medical Director Lucille Marchand named UW Palliative Care Services Director Lucille (Lu) Marchand, MD, BSN, is currently a professor of family medicine at the University of Wisconsin School of Medicine, but soon will be joining the faculty at the University of Washington Department of Family Medicine as section chief of palliative care and medical director of the UWMC Inpatient Palliative Care Service effective September 1, 2014. Lu received a BA in sociology from Brown University and did qualitative research. She subsequently obtained a BS in nursing from the Creighton University Accelerated Nursing Program in Omaha, Nebraska. During her seven years as a coronary care nurse and emergency department nurse in Oakland, CA, she completed pre-medical studies at the University of California-Berkeley. She received her MD degree from the University of California- San Francisco in 1987 and completed her family practice residency at the University of Connecticut in 1990. She also completed a fellowship in 1991 at the University of Connecticut in faculty development. Her fellowship included training in family therapy with Jeri Hepworth, PhD, and qualitative research with William Miller, MD, and Ben Crabtree, PhD. Following fellowship, she joined the University of Wisconsin Department of Family Medicine in November 1991. She was a faculty physician and clinic director at UW Health Belleville, a rural residency clinic for 14 years, and was the clinical director of integrative oncology at the UW Paul P Carbone Comprehensive Cancer Center for 7 years, and at UW Health Oncology for 3 years. She was also a physician consultant with the UW Integrative Medicine Program and the course director for the Healer's Art Medical Student elective which began in 2003. She is coordinator of the palliative care residency curriculum and was associate coordinator of the behavioral science curriculum, did mixed methods research on primary care, palliative care, curriculum development, and behavioral issues, and taught family medicine residents and medical students. Her interests include family systems, the doctor-patient relationship, narrative medicine, integrative and palliative care, spirituality, ethics, health professional well-being, and humanities in medicine. She writes prose and poetry and encourages others to write for selfreflection and publication. She has been the editor of the “Art of Caring” column in the American Academy of Hospice and Palliative Medicine Quarterly since 2004. She is board certified in family medicine, palliative medicine and integrative holistic medicine. Her most recent research interests are in life review and social networking as a therapeutic tool for patients with advanced cancer. She is currently medical director of the St Mary’s Hospital Inpatient Palliative Care Service, which is the teaching hospital for the UW Family Medicine Residency Program. Her administrative role at the University of Washington will include clinical work, teaching, and research. She is looking forward to continued involvement in the Healer’s Art Medical Student Elective Course. Lu has 2 children: Noah who is 20 years old and very autistic, and Sarah who is 23 years old and just graduated from Lewis and Clark College. Both live in Madison, WI. Her hobbies include tango dancing, yoga, hiking, skiing, biking, kayaking, reading, writing, cooking for friends, eating fresh fish, and singing kirtan. Her significant other, John Riggs, is a landscape photographer and has a photography gallery called Tamarack Studio and Gallery in Madison, WI. He is looking forward to the landscapes of the northwest. She can be reached at Lucille.Marchand@gmail.com. Harborview Medical Center 2014 Palliative Care Conference April 28 & 29 Harborview will hold it’s annual Palliative Care Conference this year on April 28th and 29th. The conference is jointly sponsored by Harborview Clinical Education and the Palliative Care Center of Excellence. Due to its popularity, it will be expanded to a 2-day event and will be held at the HMC Research & Training Building main floor. The morning of day one of the conference will focus on state of the art research in palliative care and offer a chance for research networking. The afternoon will offer experiences in complementary therapies in palliative care. Day two will be a series of educational lectures in clinical palliative care. Dr. Rebecca Sudore, from the University of California, San Francisco is our guest speaker and will be presenting “Deconstructing the Process of Advanced Care Planning” on Monday and “Making Advanced Care Planning Easier” on Tuesday. Anyone is welcome to attend! CEUs will be available for RNs. CLICK HERE for more information including how to register. Taryn Lindhorst Honored w ith Social Work Aw ard Taryn Lindhorst, School of Social Work Carol LaMare Associate Professor, is the 2014 recipient the national Social Work Hospice & Palliative Care Network Award of Excellence in Research and Education. This award recognizes Taryn's career-long devotion to advancing social work services, education and research to promote humane care at the end of life. Through the Carol LaMare program, she has worked to build an infrastructure of support and collaborative partnerships that will benefit future graduates in medical social work. Taryn chairs the School's MSW health practice concentration, has developed the practice curriculum and elective courses, and teaches core methods courses. As an expert in mixed methods research, she teaches an interdisciplinary, doctoral-level methods course on qualitative research design and is a mentor to students and faculty undertaking qualitative research projects. Taryn is a also member of the leadership team of the UW Palliative Care Center of Excellenceone of few centers in the country that focus on the development of clinicians, educators and researchers adept in work with people facing serious illness or who are at the end of life. Says Randall Curtis, her colleague and center director: "Dr. Lindhorst is a true example of the interdisciplinary, practice-based scholar and educator. She has depth in her own field and is able to use her knowledge to educate others across a variety of practice areas to advance the field of palliative social work." 5th Annual Ethics in Health Care: Perspectives and Applications 5th Annual Ethics in Health Care: Perspectives and Applications Tuesday, May 6, 2014 8:00 am—12:00 noon Virginia Mason Medical Center Volney Richmond Auditorium “The Ethics of Pain Management” Featuring guest speakers: Mark Sullivan, MD, PhD Department of Psychiatry and Behavioral Sciences School of Medicine University of Washington Mimi Pattison, MD Chair, Medical Quality Assurance Commission Washington State Department of Health Claire Trescott, MD Medical Director, Primary Care Services Group Health Cooperative CLICK HERE for more information and registration details Andrew McCor mick w ins Editors Choice Aw ard Dr.Andrew McCormick has been awarded the Editors Choice Award for his article “Buddhist Ethics and End of Life Care Decisions” by the Journal of Social Work in End-of-Life & Palliative Care which was published in April 2013. “It's gratifying to receive this award and I hope it helps practitioners working with people at the end of their lives appreciate the variance among people who come from one religious background. As I've learned more about Buddhism I've learned that like Christianity and I'm sure other religions, there are many traditions from which people approach important decisions in their life. Religion and culture play a huge role in how we make decisions about our healthcare and especially decisions that have the potential of a life or death outcome. I hope to continue learning more about ethics and ethical decision making to help people navigate these issues in our modern healthcare system.” CLICK HERE to view the full text version of the article. Tony Back aw arded grant from the Arthur Vining Davis Foundation The Arthur Vining Davis Foundation has awarded Dr. Tony Back a $200,000 grant in support of PalliativeTalk, a program for improving patient-doctor communications. The primary goal of this project is to train a national cohort of Palliative Care Faculty to lead innovative communication skills courses for frontline clinicians, and to create the PalliativeTalk materials needed to do so. This project will consist of three phases: (1) develop and test a new mobile app, Goals of Care, as an innovative learning platform for talking with patients and families facing serious illness or end of life; (2) conduct a four-day train-the-trainers PalliativeTalk Faculty Retreat that will provide methods and resources, including the Goals of Care app, for participants to teach half-day PallativeTalk courses for clinicians at their home institutions; and (3) develop a new post-course social network learning tool that will extend the knowledge that PalliativeTalk Faculty and frontline clinicians gain at their PalliativeTalk training sessions, and apply that knowledge to clinical care. Randy Curtis named Outstanding Health Care Practitioner Dr. J. Randall Curtis, Director of the Palliative Care Center of Excellence, has been named Outstanding Health Care Practitioner as part of Seattle Business Magazine’s 2014 Leaders in Health Care Awards. Dr. Curtis’s first impressions of the need for palliative care occurred during the AIDS crisis of the 1980s. As with most medical students of his generation, it was a formative experience. “I had the opportunity to see end-of-life care done very well in one room and just plain awfully in the next,” he says. “It made me think how to ensure we did it well every time and with every patient.” Curtis’s work as a critical care physician has given him plenty of chances to use palliative care practices not only for patients at the end of life but also to give greater comfort to the seriously ill. His years of research and leadership have led to our newly launched Palliative Care Center of Excellence. In what was once a fringe field, Dr. Curtis has been a vocal advocate for caring for families of the seriously ill, which he says is often more important to patients than how they themselves are cared for. That development has led to huge changes, but the biggest, he notes, is “I don’t find myself having to defend the importance of this anymore.” UW Medical Center receives Joint Commission Certification for Inpatient Palliative Care Program The Joint Commission, a national nonprofit aimed at improving public health through evaluation and accreditation of exceptional health services, has awarded UW Medical Center Advanced Certification for their 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 advanced 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.” Dr. Jaqueline Raetz, UW assistant professor of family medicine and interim director of clinical care for the UW Medical Center Palliative Care program, headed up the certification process. At the forefront of this certification is the UWMC palliative care team’s “care plan,” a document used with each and every patient receiving palliative care. The care plan reflects the patient’s current plan of care in several interdisciplinary domains that are key to providing good palliative care, such as goals of care, social circumstances, psychological status, cultural and spiritual values, grief and loss, symptom management, and advance directives, among others. Since patients with serious illness often have several care providers, ranging from nurses to surgeons to social workers, this information helps all providers keep the patient’s wishes priority. Dr. Raetz says, “It has been an honor to be a part of the palliative care team here at UWMC and I'm glad that I have been able to assist the program in achieving certification. The Advanced Palliative Care Program at UWMC was founded by Dr. Stuart Farber in 2005 and led until recently by him. He is a UW Professor of Family Medicine, and Chair of Clinical Operations for the UW Palliative Care Center of Excellence. Stu Farber initiated the process of Joint Commission Advanced Certification in Palliative Care at UW Medical Center. Dr. Farber says, “The Joint Commission Certification is recognition of the superb work our palliative care team does on a daily basis. I am extremely proud of the team and especially the exemplary leadership of Dr. Raetz that resulted in a perfect certification rating without any recommendations for improvement.” Palliative Care and Hospice E mploy ment Opportunities If you would like to find out about local and regional employment opportunities in palliative care, you can visit the PCCE Website at http://www.uwpalliativecarecenter.com/employmentopportunities.html. If you would like to have a position listed on our website, please email Jimmy Hoard at pallcntr@uw.edu. Palliative Care Research Study Participation If you are interested in participating in a research study involving palliative care, you can visit our website to find out about currently studies that may be enrolling participants. The weblink is http://www.uwpalliativecarecenter.com/research-studies.html. If you would like to have a research study listed on our website, please email Jimmy Hoard at pallcntr@uw.edu. PCCE Members Bibliography *Articles listed are 2014 publications in peer-reviewed journals and book chapters. If you have an article you would like to have featured, please email pallcntr@uw.edu. deMaine JB. Sorry Seems to be the Hardest Word. Penn Medicine. 2014; XXV, 1: 37-8 http://www.uphs.upenn.edu/news/publications/PENNMedicine/files/winter_2014_sorry.pdf Doorenbos, A. Z., Gordon, D. B., Tauben, D., Palisoc, J., Drangsholt, M., Lindhorst, T., Danielson, J., Spector, J., Ballweg, R., Vorvick, L., & Loeser, J. D. (2013). A blueprint of pain curriculum across prelicensure health sciences programs: One NIH pain consortium center of excellence in pain education (CoEPE) experience. Journal of Pain, 14(12), 1533-1538. PMCID: PMC 3855868 Holloway RG, Arnold RM, Creutzfeldt CJ, Lewis EF, Lutz BJ, McCann RM, Rabinstein AA, Saposnik G, Sheth KN, Zahuranec DB, Zipfel GJ, Zorowitz RD; on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, and Council on Clinical Cardiology. Palliative and end-of-life care in stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association [published online ahead of print March 27, 2014]. Loggers ET, Prigerson HC. The end-of-life experience of patients with rare cancers. Rare Tumors (in press). Long AC, Engelberg RA, Downey L, Kross EK, Reinke LF, Feemster LC, Dotolo D, Ford DW, Back AL, Curtis JR. Race, Income and Education: Associations with Patient and Family Ratings of End-of-Life Care and Communication Provided by Physicians-in-Training. J Palliat Med. 2014 Mar 4. [Epub ahead of print] PubMed PMID: 24592958. Johnson JR, Engelberg RA, Nielsen EL, Kross EK, Smith NL, Hanada JC, Doll O’Mahoney SK, Curtis JR. The association of spiritual care providers' activities with family members' satisfaction with care after a death in the ICU. Critical Care Medicine 2014, in press. Kundu, A., Lin, Y., Oron, A. P., Doorenbos, A. Z. (2014). Reiki therapy for postoperative oral pain in pediatric patients: Pilot data from a double-blind, randomized clinical trial. Complementary Therapies in Clinical Practice, 20, 21-25. Mead, E., Doorenbos, A. Z., Javid, S., Haozous, E., Flum, D. R., & Morris, A. M. (2013). Shared decision making for cancer care among racial and ethnic minorities: A systematic review. American Journal of Public Health, 103(12), E15-29. Neugebauer H, Creutzfeldt CJ, Hemphill JC 3rd, Heuschmann PU, Jüttler E. DESTINY-S: Attitudes of Physicians Toward Disability and Treatment in Malignant MCA Infarction. Neurocrit Care. 2014 Feb 19. [Epub ahead of print] Slatore CG, Feemster LC, Au DH, Engelberg RA, Curtis JR, Uman J, Reinke LF. Which Patient and Clinician Characteristics Are Associated with High-Quality Communication Among Veterans with Chronic Obstructive Pulmonary Disease? J Health Commun. 2014 Feb 21. [Epub ahead of print] PubMed PMID: 24558957. Tariman, J. D., Doorenbos, A., Schepp, K. G., Singhal, S., Berry, D. L. (2014). Information Needs Priorities in Patients Diagnosed with Cancer: A Systematic Review. Journal of the Advanced Practitioner in Oncology, 5, 115-122. Turnbull AE, Krall JR, Ruhl AP, Curtis JR, Halpern SD, Lau BM, Needham DM. A Scenario-Based, Randomized Trial of Patient Values and Functional Prognosis on Intensivist Intent to Discuss Withdrawing Life Support. Crit Care Med. 2014 Feb 26. [Epub ahead of print] PubMed PMID: 24584065. Vig EK, Foglia MB. The Steak Dinner-A Professional Boundary Crossing. J Pain Symptom Manage. 2014 Jan 10. pii: S0885-3924(13)00657-X. doi: 10.1016/j.jpainsymman.2013.10.011. [Epub ahead of print] PubMed PMID: 24417806. Washington KT, Demiris G, Pike KC, Kruse RL, Oliver DP. Anxiety among informal hospice caregivers: An exploratory study. Palliat Support Care. 2014; 13:1-7. Wittenberg-Lyles E, Kruse RL, Oliver DP, Demiris G, Petroski G. Exploring the collective hospice caregiving experience. J Palliat Med. 2014;17(1):50-5. If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER A Message from the Director Dece mber 2013 The leadership of the Palliative Care Center of Excellence was very excited to celebrate it’s one-year anniversary this October. We officially launched in October of 2012 and it has been a very busy and productive year. Thank you to everyone who has contributed and supported our center. We look forward to more opportunity and growth in the months to come! We were, however, deeply saddened by the news of Dr. Stu Farber’s illness. Stu, the developer and director of UWMC Palliative Care Services and the Chair of the Clinical Operations for the Center, was diagnosed recently with Acute Myelogenous Leukemia. In light of his uncertain near future, he has taken an immediate medical leave of absence, and it is not clear if he will be returning to work. We deeply appreciate all of the work, wisdom, and gifts Stu has given us, including the clinical programs he has built and his phenomenal teaching over the years. He has a caring bridge site: http://www.caringbridge.org/visit/ stuartfarber. www.uwpalliativecarecenter.org New sletter Spotlight Palliative Care: Helping Patients Improve Quality of Life The PCCE Education Operations has been very busy and we are looking forward to three important events on December 6th and The Palliative Care Center of 7th. First, we are jointly hosting a training seminar entitled, Excellence and the University of “Conducting Difficult Conversations” with the Department of Washington Marketing DepartPediatrics, which will present a model for training post-graduate ment recently worked together medical trainees in end-of-life communication. Second, our to produce this excellent video newly formed PCCE Community of Educators is holding it’s describing the benefits of palliafirst retreat to brainstorm ideas to develop palliative care educa- tive care through the stories of tion. Third, Dr. Mitchell Levy will be conducting a seminar on two patients and their families. mindfulness and communication entitled, “Let’s Talk About Click on the image below to Dying.” This workshop will be Friday evening, December 6th view this video: and Saturday, December 7th and offer CME, CNE and CEU credit for Social Workers. Details about each event are below and include links to our flyers and instructions on how to RSVP. The PCCE Clinical Operations team has been meeting monthly working towards standardizing and expanding palliative care services at all of the UW Medicine clinical sites. The four goals of the Clinical Operations are: 1) Develop and implement standards of a palliative care consultation service, both inpatient and outpatient; 2) Develop a palliative care quality dashboard and quality metrics for both primary and specialty palliative care at UW Medicine; 3) Create screening programs to identify patients with unmet palliative care needs in a routine way; and 4) Achieve Joint Commission Advanced Certification in Palliative Care at each site. The PCCE Research Operations continues to conduct monthly research seminars and works-inprogress sessions. We also held our first Palliative Care Research Think Tank on October 31 st, which was a huge success. We gathered a large, interdisciplinary group of researchers and systematically brainstormed future palliative care research ideas and ways to implement and fund these ideas. This first Think Tank focused on acute care. We look forward to holding another think tank early in 2014 focused on disparities in palliative care and will keep everyone posted on details. The PCCE has also created a Community Advisory Board. This Board serves as a place for people in our community who have had experiences with serious illness either personally or through a loved one and have a passion for palliative care to share their experiences and give our Center feedback on how the development of palliative care impacts the lives of patients and family members. If you know of anyone who you think would be interested in joining this important group, please contact us at pallcntr@uw.edu for more information. As we complete our first successful year, we are looking forward with anticipation to the years to come and have developed three main goals for the next three years and the future of the Palliative Care Center of Excellence: 1) Advance the quality of primary and specialty palliative care across UW Medicine and affiliated clinical sites; 2) Advance the quality and quantity of palliative care research and increase the number of palliative care researchers at the University of Washington thereby establishing the University of Washington as one of the top institutions nationally in palliative care research, and 3) Advance the quality and quantity of clinical education offerings in palliative care across the educational and clinical sites at the University of Washington thereby establishing the University of Washington as one of the top institutions nationally in palliative care clinical education. As always, thank you for your support and interest in the Palliative Care Center of Excellence. We welcome your feedback and look forward to your participation in the ongoing development of our Center and in providing excellent care to all patients with serious illness and their families. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine PCCE Members Research Survey —Share your Research Progress! The PCCE has developed a Research Survey to collect information about ongoing and recently completed research projects of its members. The purpose of our survey is to facilitate collaboration among members of the palliative care community, and to track the progress of palliative care research in our region. We also hope that access to this data will encourage robust future research in palliative medicine. Complete instructions on completing the survey are available now on our PCCE website: http:// www.uwpalliativecarecenter.com/research-survey.html Please take a few minutes to visit the site and tell us more about your palliative care research! Ardith Doorenbos voted in as Co -chair of the Palliative & End of Life Care Expert Panel of the A merican Acade my of Nursing Ardith Doorenbos, PhD, RN, FAAN, Associate Professor in the University of Washington School of Nursing, and Co-Chair of the UW Palliative Care Center of Excellence Research Operations was recently voted in as Co-Chair of the Expert Panel on Palliative & End of Life Care of the American Academy of Nursing. The Academy serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Every day across America, the Academy and its members create and execute knowledge-driving and policy -related initiates to drive reform of America's healthcare system. The Expert Panel on Palliative and End-of-Life Care identifies and disseminates the public policy priorities for clinical care, research and education related to palliative and end of life care. This includes legislation related to advanced care planning, importance for and recognition of the need for and coverage of hospice and palliative care its role in health care reform. Let’s talk about dying —PCCE Hosts a Dece mber 6 -7 Educational Workshop On December 6th and 7th, the PCCE will hold a workshop featuring Dr. Mitchell Levy, Professor of Medicine and Chief, Division of Pulmonary, Critical Care and Sleep Medicine at the Alpert Medical School at Brown University. The workshop is entitled, “Let’s talk about dying: Applying lessons from mindfulness to improve the quality of end-of-life care. ” This workshop is designed for medical professionals, care-givers, and family members assisting end-of-life patients. Participants will explore how aspects of the practice of meditation can help to develop insightful communication skills necessary for working with patients and families facing death. The program is designed to bring together a wide variety of participants--including practicing physicians, house-staff, nurses, social workers, lay caregivers, and others who are actively involved or concerned with end-of-life situations and decision-making. December 6th, 7:00pm—9:00pm and December 7th, 8:30am—5:00pm COST: $50 including lunch, $25 for Students $50 additional for CME/CNE/CEU credit To RSVP, send an email to pallcntr@uw.edu Mitchell M. Levy, MD, is Professor of Medicine and Chief, Division of Pulmonary, Critical Care, and Sleep Medicine at the Alpert Medical School at Brown University; and Director of the Medical Intensive Care Unit at Rhode Island Hospital. He is also an acharya (senior teacher) in the Shambhala Buddhist tradition. Dr Levy’s work in the field of palliative care draws on the Buddhist tradition to improve and deepen the communication and compassion skills of medical, psychological, and education professionals. “At no time do your words as a healthcare professional have more profound influence on patients, family, and colleagues than when providing end-of-life care.” Objectives: Upon completion of this program, the participant should be able to: Utilize new listening skills during discussions about end of life care Utilize mindfulness techniques for improving communication with patients and families in end-of-life care situations Enhanced skills for approaching and overcoming obstacles to good end of life care in the ICU and other clinical settings – discomfort associated with death and grief; heightened emotion, and avoidance behavior. Routine use of a check-list, or script for family meetings around end-of-life decisions. The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of Washington School of Medicine designates this live activity for a maximum of 8.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. *Sponsored by the University of Washington and the UW Palliative Care Center of Excellence Click on the image below for a PDF of the seminar flyer. PCCE Community of Educators Retreat —Dece mber 6th Palliative Care Center of Excellence Education Retreat Date: Friday, December 6th, 2013 Time: 1pm-5pm Location: Harborview Medical Center, R & T Building, Auditorium Who is welcome: Anyone interested in palliative care education We want to remind everyone about the Palliative Care Center of Excellence Education Retreat on the afternoon of December 6th, 2013. We will start the afternoon off with an update on current endeavors by the Educational Operations of the Palliative Care Center of Excellence and innovative practices in adult learning. We will then be dividing into the following breakout sessions a) primary palliative care education for UW trainees, b) primary palliative care education for practicing providers and c) specialty palliative care education. We will close the afternoon by coming back together as a larger group to create a roadmap for palliative care training. The aims of this retreat include establishing a repository of information about current educational resources for those that are looking for ways to integrate palliative care education now, identifying areas of need and opportunity for future educational programming, brainstorming innovative ways to expand the reach of palliative care education, and lastly creating working groups to carry these ideas forward. All are welcome so please pass along this invitation to anyone who you think may be interested in attending. You may RSVP to this event by sending an email to pallcntr@uw.edu. Sincerely, Caroline Hurd, MD Co-Chair of Educational Operations UW Palliative Care Center of Excellence Sarah Shannon, PhD, RN Co-Chair of Educational Operations UW Palliative Care Center of Excellence Click on the image below for a PDF of the event flyer. Conducting Difficult Conversations: Best Practices for Training Clinicians The Palliative Care Center of Excellence and the Department of Pediatrics are hosting a free seminar entitled “Conducting Difficult Conversations: Best Practices for Training Clinicians” on Friday, December 6th from 8:00am-12:00pm at the Harborview Medical Center Research & Training Building Auditorium. Giving serious news to patients or family members is one of the most difficult communication skills in medicine. Unfortunately, most medical trainees get very little formal instruction in effectively communicating these high-stakes scenarios. Fewer still have the opportunity to practices skills away from the bedside. Join us as we survey best practices for training residents and present a model for resident instruction across disciplines at UW Medicine. Featured Guest Speaker: Dr. Janet Serwint Professor of Pediatric Residency Program Johns Hopkins University All are welcome! Please RSVP by sending an email to Ann Marshand at marchand@uw.edu. Jointly sponsored by: Harborview Medical Center Department of Pediatrics and the UW Palliative Care Center of Excellence. Please click on the image below for a PDF of the event flyer. PCCE Members Bibliography *Articles listed are 2013 publications in peer-reviewed journals and book chapters. If you have an article you would like to have featured, please email pallcntr@uw.edu. Bays AM, Engelberg RA, Back AL, Ford DW, Downey L, Shannon SE, Doorenbos AZ, Edlund B, Christianson P, Arnold RW, O'Connor K, Kross EK, Reinke LF, Feemster LC, Edwards K, Alexander SC, Tulsky JA, Curtis JR. Interprofessional Communication Skills Training for Serious Illness: Evaluation of a Small-Group, Simulated Patient Intervention. J Palliat Med. 2013 Nov 1. [Epub ahead of print] Bensink, M. E., Eaton, L. H., Morrison, M. L., Cook, W. A., Curtis, J. R., Kundu, A., Gordon, D. B., & Doorenbos, A. Z. (2013). Cost-effectiveness analysis for nursing research. Nursing Research, 62, 279–285. Collinge W, Kahn J, Walton T, Kozak L, Bauer-Wu S, Fletcher K, Yarnold P, Soltysik R. Touch, Caring, and Cancer: randomized controlled trial of a multimedia caregiver education program. Support Care Cancer. 2012 Dec 21. [Epub ahead of print] PubMed PMID: 23262808. Doorenbos, A. Z., Juntasopeepun, P., Eaton, L. H., Rue, T., Hong, E., & Coenen, A. (2013). Palliative care nursing interventions in Thailand. Journal of Transcultural Nursing, 24(4), 332339. Kozak L, Vig E, Simmons C, Eugenio E, Collinge W & Chapko M. (2013) A Feasibility Study Of Caregiver-Provided Massage As Supportive Care In VA Cancer Patients. J. of Supportive Oncology, 2013Aug [Epub ahead of print]. Kross EK, Engelberg RA, Downey L, Cuschieri J, Hallman MR, Longstreth WT Jr, Tirschwell DL, Curtis JR. Differences in end-of-life care in the ICU across patients cared for by medicine, surgery, neurology and neurosurgery physicians. Chest. 2013 Oct 10. doi: 10.1378/chest.131351. [Epub ahead of print] Meins, A. & Doorenbos, A. Z. (2013). Healthcare provider, educator, and … ethnographer? Community health nurses as applied ethnographers in Tamil Nadu, India. Sri Ramachandra Nursing Journal, 5, 4-6. Murphy, A., Siebert, K., Owens, D., & Doorenbos, A. Z. (2013). Healthcare utilization by patients whose care is managed by a primary palliative care clinic. Journal of Hospice and Palliative Nursing, 15(7), 372-379. Ralston-Wilson, J., Tseng, A., Oberg, E., Sasagawa, M., Doorenbos, A. Z., Kundu, A. (2013). Utilization of acupuncture therapy among pediatric oncology patients at a tertiary care pediatric hospital. Alternative and Integrative Medicine, 2, 129. Doi:10.4172/2327-5162.10000129 Rosenberg AR, Wolfe J, Bradford M, Shaffer M, Yi-Frazier J, Curtis JR, Syrjala KL, Baker KS. Resilience and psychosocial outcomes of caregivers of children with cancer; Pediatric Blood and Cancer; [Epub ahead of print]; Nov 19, 2013; PMID 2424926 Sprung CL, Danis M, Iapichino G, Artigas A, Kesecioglu J, Moreno R, Lippert A, Curtis JR, Meale P, Cohen SL, Levy MM, Truog RD. Triage of intensive care patients: Identifying agreement and controversy. Intensive Care Medicine 2013 Nov;39(11):1916-1924. PMID: 23925544 Tsou AY, Creutzfeldt CJ, Gordon JM. The good doctor: professionalism in the 21st century. Handb Clin Neurol. 2013;118:119-32. doi: 10.1016/B978-0-444-53501-6.00009-3. PMID: 24182371 [PubMed - in process] Van Hyfte G & Kozak L and Lepore M. (2013). Administration and Utilization of complementary and Alternative Medicine in Illinois Hospice and Palliative Care Organizations. Am J Hosp Palliat Care. 2013 Aug 12. [Epub ahead of print] PubMed PMID: 23943631. Wittenberg-Lyles E, Goldsmith J, Oliver DP, Demiris G, Kruse RL, Van Stee S. Exploring oral literacy in communication with hospice caregivers. J Pain Symptom Manage. 2013 Nov;46 (5):731-6. If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER A Message from the Director Septe mber 2013 The Palliative Care Center of Excellence has had a productive Summer and is looking forward to an exciting Fall. Our Research Operations recently held its first Works in Progress led by the Director of our Metrics, Quality & Evaluation Core, Dr. Helene Starks. We also welcomed our first visiting professor, Dr. Susan Enguidanos who presented at our August PCCE Research Conference. Susan Enguidanos, Ph.D., is the Hanson Family Trust Assistant Professor of Gerontology at the Davis School of Gerontology at the University of Southern California and is principal investigator of a study testing a social work intervention to improve care setting transitions among older adults as they move from hospital to home. Our Clinical Operations leadership are working with the Palliative Care Clinical Services at each site on three tasks: a) meet or exceed our PCCE standards of care, b) develop and implement our palliative care quality metrics and dashboard, and c) develop and implement screening tools to identify patients and families with unmet palliative care needs. In terms of the standards, all of the clinical services are busy and continue to expand and grow; we are working toward meeting the standards at each site. Since the last newsletter, we welcome Sharon Stephen, ARNP to the Palliative Care Center of Excellence. She will be building the first palliative care program at Valley Medical Center. In terms of metrics, we have created a set of draft metrics for palliative care services across UW Medicine and Dr. Starks is leading an effort to implement these. The metrics will assess the quality of palliative care specialty services as well as the quality of primary palliative care delivered by the healthcare system. Implementation of these metrics will help assess, standardize, and improve palliative care across UW Medicine. You can read more about our progress and plans in Dr. Starks message below. Finally, in terms of screening tools, we are working toward routine screening of patients with palliative care needs at each of our clinical locations. www.uwpalliativecarecenter.org New sletter Spotlight Dr. J Randall Curtis receives the 2013 Sojourns Award from Cambia Health Foundation Dr. J. Randall Curtis, Director of the UW Palliative Care Center of Excellence and A. Bruce Montgomery - American Lung Association Endowed Chair in Pulmonary & Critical Care Medicine, has been given the 2013 Sojourns Award from Cambia Health Foundation for his work in Palliative Care. Cambia Health Foundation works in collaborative and innovative ways to advance palliative care. Cambia created the Sojourns Award to honor exemplary leaders and organizations The Education Operations, led by Dr. Caroline Hurd, has in the field of palliative care planned a December Retreat for our newly formed “Community whose work improves access to of Educators.” This retreat will include clinicians and educators and education about palliative from all disciplines who want to help mold the future of palliacare and creates innovative solutive care education and training. You can read details about the tions. Since 2010, Cambia has upcoming event in Dr. Hurd’s message below. Other planned awarded $700,000 in grants to educational events include: Sojourns Award winners who September 26: Medical Grand Rounds entitled “Innovation are leaders in the care of seriin Communication about End-of-Life Care: Using Vid- ously ill people. The goal of the eos and System-Level Change to Improve Care”. Dr. Sojourns Award is to promote Angelo Volandes, who is an internist and researcher at innovations and invest in their Harvard Medical Center and Massachusetts General future work. The award celeHospital and will be giving UW Medicine Grand brates individual leaders and Rounds. organizations in Idaho, Oregon, December 6 and 7: “Let’s Talk About Dying: Applying Utah and Washington, who Lessons from Mindfulness to Improve the Quality of strive to advance the access, End-of-Life Care.” This is a 1 ½ day retreat led by Dr. quality and understanding of Mitchell Levy, Professor of Medicine and Chief of the palliative care locally and naDivision of Pulmonary, Critical Care and Sleep Medi- tionally. Recipients of Sojourns cine at the Alpert Medical School at Brown University. Award receive a $50,000 grant to advance their work. Details of these presentations are included in this newsletter. As always, thank you for your support and interest in the Palliative Care Center of Excellence. We welcome your feedback and look forward to your participation in the ongoing development of our Center and in providing excellent care to all patients with serious illness and their families. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine PCCE Clinical Update: UW/Valley Medical Center Launches Palliative Care Consult Service When I arrived at UW/Valley Medical Center, every time I mentioned palliative care, the response was “Brick Wall”. I was happy to learn this wall was not a barrier to palliative care, but the physician champion who now serves as the Medical Director of the new Palliative Care Service. Another surprise was that all the Critical Care Intensivists are vying to be Physician Champions for palliative care. All twenty Southlake Clinic Hospitalists are on board! When I remark about their attention to palliative care issues in daily progress notes, I hear “my mother’s a hospice nurse” or “my wife’s a Palliative Care ARNP!” Okay, we have critical mass and I nervously retrieve Diane Meier’s 2005 article entitled “Planning for the Mixed Blessing of Unexpected Growth!” My next VMC lesson is about the C Suite, the section of offices for the CEO, COO, CMO, CNO, CFO et al. Not only are each of these leaders visible and accessible, but several members are regularly dialed into conference calls for the leadership of Palliative Care across the UW system. They have the difficult task of sustaining the services at VMC through fiscal responsibility that has required reductions in forces and furlough days, but fortunately they have the courage and wisdom to add positions for Palliative Care. As of Monday this week, we have just grown to a department with 2.1 dedicated FTEs. Chaplain Donna has been providing spiritual care palliative care services for the past 4 years prior to my arrival as the Director of Palliative Care and the program’s first ARNP. Chaplain Donna responds to all code blue emergencies and covers the entire hospital with the assistance of volunteers. She is passionate about palliative care, a member of the Washington State Hospice Association, and spent a chaplain training rotation at the Franciscan Hospice House. She is also a member of the VMC ethics committee and orients all new employees to Advanced Directives. We started the consult service 7 weeks ago, limiting the consults to the critical care area with plans to follow patients out to the wards. Thus far we have completed 30 new consults and 90 follow-up visits; 13 patients have been discharged (7 on hospice, 2 on home health, 2 to rehab, 1 to LTAC, and 1 home). To date there have been no readmissions of the palliative care patients discharged. Thirteen patients referred for palliative care died in the hospital on comfort care. We have received numerous calls from families reporting how much palliative care has helped them navigate a difficult time of their lives. - Sharon Stephen, PhD, ARNP, ACHPN As chair of clinical operations for the PCCE I recently had the privilege of spending a busy day shadowing Sharon Stephens DNP at Valley Medical Center as well as meeting with Brick Wall MD, Kathryn Beattie MD Chief Medical Officer, and Scott Alleman Senior Vice President for Patient Services. The support and appreciation for Sharon’s palliative care efforts from patients, families, clinicians and administration was readily apparent. The PCCE looks forward to supporting Sharon and the administration at VMC in growing a quality service that integrates with the other UW Medicine programs. - Stuart Farber, MD University of Washington Launches Palliative Care Training Center Palliative Care programs are growing rapidly in the US due to the demonstrated increased quality of care and improved resource utilization these programs facilitate. The State of Washington is no exception. However, the growing shortfall in qualified palliative providers across the state and around the country is a significant barrier to expanding palliative care services. In recognition of the need for an expanding palliative workforce, the Cambia Foundation has awarded the UWSOM a $697,106 grant to develop a collaborative regional Palliative Care Training Center for specialty level providers over the next three years. This project is a partnership between the UW PCCE and state sponsors. Sponsors include the Washington State Hospice and Palliative Care Organization, Washington State Hospital Association, the Washington State Medical Association, and community stakeholders such as health care systems, hospices, palliative care programs, nursing homes, consumers and others. The Palliative Care Training Center will assess stakeholder needs, identify core competencies needed by new palliative care providers, and have expert faculty from the PCCE work in collaboration with the stakeholders to design and implement a cutting-edge, adult-centered curriculum that will lead to basic certification in specialty level palliative care. Our expert interdisciplinary faculty is led by Stu Farber, MD, the principal investigator for the grant and leader of the project. Other expert faculty include Ardith Doorenbos, PhD, from the School of Nursing, Taryn Lindhorst, PhD from the School of Social Work, Helene Starks, PhD, from the Department of Bioethics and Humanities, Larry Mauksch MEd, Senior Lecturer in the Department of Family Medicine, Tony Back, MD, Co-Director of the PCCE from the Division of Oncology in the Department of Medicine, and Randy Curtis, MD, Director of the PCCE from the Division of Pulmonary and Critical Care Medicine in the Department of Medicine. This project has four phases: Year 1: Bring key stakeholders from the community of palliative care service providers together with faculty from the PCCE to assess needs, identify core competencies and develop a funding model that will allow the Palliative Care Training Center to be self -sustaining at the end of the grant period. Year 2: Faculty from the PCCE will develop and beta test a cutting- edge, adult-centered curriculum in collaboration with our community sponsors and key stakeholders. Year 3: Faculty from the PCCE will implement the curriculum with an interdisciplinary group of twenty or more learners from around Washington State leading to basic certification in specialty-level palliative care while carefully measuring outcomes. Year 4 and beyond: Faculty, in collaboration with our community sponsors and key stakeholders, will offer regional training throughout Washington State sustained by an acceptable funding model. The grant began in July 2013 and meetings with our state sponsors have already been productive. We are identifying key stakeholders that represent the wide diversity of providers and consumers of palliative care across the state. A few examples of the factors we are considering include urban versus rural context, care settings (hospital, home, nursing home), healthcare delivery systems, and consumer perspectives. We are planning our initial stakeholders webinar in November 2013 to begin exploration of needs, identify core competencies and create a stakeholder’s steering committee that will collaborate with faculty from the PCCE in curriculum development and creating a sustainable funding model. “As Principal Investigator for this grant I deeply appreciate Cambia Health Foundation’s support and vision. The successful implementation of this grant will have a tremendous impact on our region by providing a uniformly high standard of palliative care practice throughout the State of Washington. Our team of expert faculty is excited for the opportunity to work collaboratively with palliative care providers across the state to create a Palliative Care Training Center that provides cutting edge inter-professional education and can serve as a successful national model,” said Stu Farber, M.D., Professor, Department of Family Medicine and Chair of Clinical Operations for the Palliative Care Center of Excellence. If you have questions or are interested in participating in this project please email Stu Farber MD at sfarber@uw.edu. Dr. Angelo Volandes to visit the University of Washington Dr. Angelo Volandes will be visiting the University of Washington this month to meet with the leaders of the Palliative Care Center of Excellence and present at the UW Department of Medicine Medical Grand Rounds. His talk is entitled, "Innovation in Communication about End-ofLife Care: Using Videos and System-Level Change to Improve Care" and will be at the UWMC T-Wing T625 lecture hall on Thursday, September 26th at 8:00am. Dr. Volandes is an Assistant Professor of Medicine at Harvard Medical School/Massachusetts General Hospital and the CoFounder/President of Advance Care Planning Decisions . "Dying patients often receive aggressive, expensive treatment that many would reject if they had a fuller understanding of their options, writes Dr. Angelo Volandes. A series of videos showing what end-of-life care really looks like has allowed patients at a handful of hospitals to make better informed choices. An intervention that first and foremost leads to better patient-centered health care — and also happens to lower costs — is a good thing, and more hospitals should embrace it." More information on his work: http://www.theatlantic.com/magazine/archive/2013/05/how-notto-die/309277/ Cambia Health Foundation 2013 Sojourns Aw ards The Cambia Health Foundation created the Sojourns Award to honor exemplary leaders in the field of palliative care, to promote their innovations and to invest in their future work. This year’s recipients are Kevin Clifford, MD, Palliative Care Service Medical Director at St. Alphonsus Regional Medical Center, J. Randall Curtis, MD, MPH, Director of the Palliative Care Center of Excellence at the University of Washington, Erik K. Fromme, MD, MCR, FAAHPM, Palliative Care Service Medical Director, Oregon Health and Science University, Susan Hedlund, MSW, LCSW, OSW-C, from the Knight Cancer Institute, Oregon Health Sciences University, and Holli Martinez, FNPBC, ACHPN, Palliative Care Service Program Director, University of Utah Health Care. Details about the awards presentation are below: American Cancer Society Palliative Care Pilot Projects The American Cancer Society in parallel with the National Palliative Care Research Center is launching Pilot and Exploratory Projects in Palliative Care of Cancer Patient and their Families. The purpose is the development of the specialty of palliative medicine as a critical step in addressing the unmet needs of patients with serious illness and their families Pilot data are typically needed before funding agencies (e.g., NIH, VA or the American Cancer Society) will consider funding a research project. In an effort to support clinician investigators conducting patient-oriented research in palliative care, the American Cancer Society, in parallel with the National Palliative Care Research Center (NPCRC), is soliciting applications for pilot/ exploratory research grants in palliative care of cancer patients and their families. These grants will generate the pilot data necessary to maximize an investigator's chances of competing successfully for larger grants. Application Deadline: October 15, 2013 For more information, visit their website at: http://www.cancer.org/research/ applyforaresearchgrant/granttypes/rfa-palliative-care-cancer-patients PCCE Community of Educators Retreat —SAVE THE DATE! Palliative Care Center of Excellence Education Retreat Date: Friday, December 6th, 2013 Time: 1pm-5pm Location: Harborview Medical Center, R & T Building, Auditorium Who is welcome: Anyone interested in palliative care education We want to remind everyone to mark their calendars for the Palliative Care Center of Excellence Education Retreat on the afternoon of December 6 th, 2013. We will start the afternoon off with an update on current endeavors by the Educational Operations of the Palliative Care Center of Excellence and innovative practices in adult learning. We will then be dividing into the following breakout sessions a) primary palliative care education for UW trainees, b) primary palliative care education for practicing providers and c) specialty palliative care education. We will close the afternoon by coming back together as a larger group to create a roadmap for palliative care training. The aims of this retreat include establishing a repository of information about current educational resources for those that are looking for ways to integrate palliative care education now, identifying areas of need and opportunity for future educational programming, brainstorming innovative ways to expand the reach of palliative care education, and lastly creating working groups to carry these ideas forward. All are welcome so please pass along this invitation to anyone who you think may be interested in attending. We will be sending out a separate invitation with a request for your RSVP in the coming weeks. Sincerely, Caroline Hurd, MD Co-Chair of Educational Operations UW Palliative Care Center of Excellence Sarah Shannon, PhD, RN Co-Chair of Educational Operations UW Palliative Care Center of Excellence Let’s talk about dying —PCCE Hosts a Dece mber Educational Workshop On December 6th and 7th, the PCCE will hold a workshop featuring Dr. Mitchell Levy, Professor of Medicine and Chief, Division of Pulmonary, Critical Care and Sleep Medicine at the Alpert Medical School at Brown University. The workshop is entitled, “Let’s talk about dying: Applying lessons from mindfulness to improve the quality of end-of-life care. ” This workshop is designed for medical professionals, care-givers, and family members assisting end-of-life patients. Participants will explore how aspects of the practice of meditation can help to develop insightful communication skills necessary for working with patients and families facing death. The program is designed to bring together a wide variety of participants--including practicing physicians, house-staff, nurses, social workers, lay caregivers, and others who are actively involved or concerned with end-of-life situations and decision-making. Dr Levy’s work in the field of palliative care draws on the Buddhist tradition to improve and deepen the communication and compassion skills of medical, psychological, and education professionals. “At no time do your words as a healthcare professional have more profound influence on patients, family, and colleagues than when providing end-of-life care.” SAVE THE DATES!!! December 6th, 7:00pm—9:00pm and December 7th, 8:30am—5:00pm WATCH FOR DETAILS TO COME! PCCE’s First Think Tank Conference The Palliative Care Center of Excellence will host its first Research Think Tank session on October 31st, 2013. Two important goals of the PCCE Research Operations are supporting innovative research and creating collaborative research partnerships. As part of this, the PCCE will be hosting the first Research Think Tank in order to generate future palliative care research proposals in the acute care and ICU settings. The goal is to gather a diverse and creative group of researchers and clinicians together to identify problems, research questions, methodology, and potential collaborations both within and across disciplines. Contact Dr. Erin Kross (ekross@uw.edu), chair of the session, or Jimmy Hoard (jthoard@uw.edu) for more information. PCCE Members Bibliography *Articles listed are 2013 publications in peer-reviewed journals and book chapters. If you have an article you would like to have featured, please email pallcntr@uw.edu. Downey L, Au DH, Curtis JR, Engelberg, RA. Life-sustaining treatment preferences: Matches and mismatches between patients’ preferences and clinicians’ perceptions. J Pain Sympt Mgmt 2013;46(1):9-19. Farber S and Farber A, Chapter 8: It Ain’t Easy: Making Life and Death Decision Before the Crisis, McCune S and Rogne L Eds, Advance Care Planning: Communicating About Matters of Life and Death, NY,Springer Publishing, 2013. Kelley M, Demiris G, Nguyen H, Oliver DP, Wittenberg-Lyles E. Informal hospice caregiver pain management concerns: a qualitative study. Palliative Medicine 2013;27(7):673-82. Long AC, Curtis JR. Physicians’ decision-making roles for critically ill patients: What is the “right” approach? (editorial) Critical Care Medicine. 41(6):1587-1588, June 2013. McCormick, A. J. (2013). Buddhist Ethics and End-of-Life Care Decisions. Journal of Social Work in End-of-Life and Palliative Care, 9:209-225. Nelson JE, Curtis JR, Williams CD, Mulkerin C, Campbell M, Lustbader DR, Mosenthal AC, Puntillo K, Ray DE, Basset R, Boss RD, Brasel KJ, Cortez TB, Frontera JA, Hays RM, Weissman DE, for The IPAL-ICU Advisory Board. Choosing and using screening criteria for palliative care consultation in the ICU: A report from the IPAL-ICU. Crit Care Med. 9 Aug 2013. Vicki A. Jackson, Juliet Jacobsen, Joseph A. Greer, William F. Pirl, Jennifer S. Temel, and Anthony L. Back. Journal of Palliative Medicine. August 2013, 16(8): 894-900. doi:10.1089/ jpm.2012.0547. Zaros MC. Curtis JR, Silviera MJ, Elmore JG. Opportunity lost: End-of-life discussions in cancer patients who die in the hospital. J Hosp Med 2013;8:334-340. If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER A Message from the Director We have had an exciting quarter since our March newsletter was published. Our April Community Forums attracted a diverse group of attendees which included patients, family members and all types of care providers interested in sharing their stories and providing input on the development of Palliative Care in the region. We listened as attendees told us about their experiences, both positive and negative. We discussed that many patients and families are told by their physicians that it is “too soon” for palliative care. The difficulty finding palliative care trained clinicians was also frequently raised as an important issue. The forum discussions generated recommendations for public education as well as clinician education in areas such as correcting misconceptions about palliative care. We look forward to continuing to learn from patients and family members. The Palliative Care Center of Excellence will be holding more forums in the future and will take the information we glean from them to continue to enhance the care given to patients with serious illness. During the forums, we also successfully recruited several new members into our Community Advisory Board. Our board is a direct way for members of the community can become involved in helping the PCCE meet its goals of improving the lives of patients with serious illness and their families. June 2013 www.uwpalliativecarecenter.org New sletter Spotlight VITALTALK Vitaltalk is the first iPhone app designed to improve the communication skills for clinicians who talk to patients about serious news. It's based on 5 simple Our Clinical Operations continues to grow and expand with the steps that spell "GUIDE" bedevelopment of the Regional Training Center for Palliative Care. cause that's what giving bad Led by Dr. Stu Farber and funded by the Cambia Foundation, news about now--in the age of the Training Center will focus on developing a palliative care communication skills 2.0, clinitraining and certification program to educate palliative care pro- cians need to do more than just viders in the UW Medicine health care system and in the region. disclose. What patients tell us, in The Regional Training Center is being funded by a generous a number of studies, is that they grant from the Cambia Foundation that will get the Training want the clinician to point them Center started and allow it to create the infrastructure to be self- in the right direction. sustaining in the future. University of Washington Medical Center, Harborview Medical Center, Valley Medical Center and What's different about the VitalNorthwest Hospital and Medical Center have all welcomed new Talk app? It's designed for point members of their palliative care services and we look forward to -of-care, just-in-time learning more growth and welcome all of the new team members to these that is based on a deliberate clinical services. With the help and hard work of Helene Starks, practice model. If you haven't head of our Informatics Core, we have created a set of draft met- heard of deliberate practice, it's rics for palliative care services across UW Medicine. These how experts get better at what metrics will assess the quality of palliative care specialty serthey do--they break down the vices as well as the quality of primary palliative care delivered complex task into small bits, and by the healthcare system. Implementation of these metrics will focus on one bit at a time. That's help assess, standardize, and improve palliative care across UW what the VitalTalk app does. Medicine. The home screen shows the steps (so you don't have to go The Palliative Care Center’s Education Operations recently sent further than home for a quick out a call for a “Community of Educators” from all disciplines reminder); and home also has a who want to help mold the future of palliative care education 'prepare me' button--that enables and training. The response has been a bit overwhelming and a learner to focus on one disvery encouraging! Our focus will encompass three main docrete skill. There's also a 'debrief mains: A) Trainee education (pre-licensure, post-licensure and me' button--that enables a learnadvanced practice), B) Current UW Medicine and UW provider to set a reminder so they can ers, and C) The greater northwest and WWAMI community. think back on what happened, Activities will include curriculum development, interdebrief themselves, troubleprofessional education events, certification courses, continuing shoot. It's a new learning plateducation retreats and conference organization, onboarding pro- form for communication skills. grams and mentorship. Be watching for more information from https://itunes.apple.com/app/ Caroline Hurd and Sarah Shannon, our clinical operations lead- id639969220 ers, about the development of these goals. We are up and running with many new activities from our Research Operations which are detailed below in an update from our research operations leadership. As always, thank you for your support and interest in the Palliative Care Center of Excellence. We welcome your feedback and look forward to your participation in the ongoing development of our Center and in providing excellent care to all patients with serious illness and their families. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine PCCE Research Operations Update This month we feature what’s happening with the Research Core and invite you to participate in some upcoming activities that support our long-term goal: “To improve palliative care received by patients with life-limiting illness and their families through the acquisition of new knowledge derived from innovative research, collaborative research partnerships, supportive research infrastructure and advancing career development disseminated broadly to concerned stakeholders and communities.” There’s something for everyone here – works-in-progress seminars and research conferences to showcase work in development and completed studies and a mentoring network where early investigators can get help and guidance. We are also developing a searchable database of current and recently-completed research in palliative care to facilitate collaborations between researchers and students. Have a project that needs some advice about analysis? Are you a student looking for a project? Want to learn what research is happening? The PCCE Resource Repository will be your first stop. Researchers – look for a link to our survey in your inbox soon! Because we are a community, we invite you, the members of the PCCE, to help us shape the Research component so that we are able to advance your goals and meet your needs as palliative care researchers, clinicians and educators. We are looking forward to extending the Research activities of the PCCE to the entire palliative care community. Below are details about our current and planned activities. Please note the following recurring activities on your calendars: Palliative Care Center of Excellence (PCCE) Research Seminars: Current research findings from the palliative care research community. When/where: 4 th Tuesday of each month, 8-9:00 AM, HMC Pat Steel Building, Room 2097, Telecast to UWMC Room E-304 Works in Progress: Informal presentations of proposed or on-going research projects to gather feedback, suggestions, guidance and direction. When/where: Quarterly, 4 th Tuesday of each month, 8-9:00 AM, HMC Pat Steel Building, Room 2097, Telecast to UWMC Room E-304 Mentor/Mentee development, support and guidance: Facilitate development of the next generation of palliative care researchers through one-on-one mentorship. If you’re looking for a mentor, contact us and we’ll help you find one! In progress: Think Tank Conferences: A local “research summit” to advance the development of innovative approaches to palliative care research, with a particular focus on interdisciplinary collaboration within and across UW Medicine, UW Health Sciences Schools and other hospitals and hospice institutions. Mock Study Sections: Get excellent advice and improve the chances of securing funding by having your grant reviewed before submission. Let us know if you have a grant in preparation for the Fall and would like time, or if you would like to serve as a reviewer. We welcome your feedback and participation. If you have suggestions for us, or would like to participate directly in any of the planning meetings and activities, please contact us (see below) or our administrator, Jimmy Hoard. Ardith Z. Doorenbos, PhD, RN, FAAN Email: doorenbo@uw.edu Ruth Engelberg, PhD Email: rengel@uw.edu Taryn Lindhorst, PhD tarynlin@uw.edu Helene Starks, PhD Email: tigiba@uw.eud Dr. Randy Curtis Receives PCORI Aw ard Dr. J. Randall Curtis, A. Bruce Montgomery-American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine has been selected as a recipient of grant from the PatientCentered Outcomes Research Institute. This award provides three years of support for a study led by Dr. Curtis, Dr. Ruth Engelberg, and others titled “Health system intervention to improve communication about end-of-life care for vulnerable patients.” This study seeks to ensure that patients receive the care they desire in the event of a serious illness through improved patientclinician and family-clinician communication about the patient’s goals of care. The study is supported by the new UW Palliative Care Center of Excellence. For more details about the project CLICK HERE. Dr. Wayne McCormick elected President -Elect of AGS Wayne McCormick, Medical Director of Bailey Boushay House, Section Chief of the UW Medicine Long Term Care Service, and head of the Palliative Care Fellowship Program has been elected President Elect of the American Geriatrics Society. The American Geriatrics Society (AGS) is a not-for-profit organization of over 6,000 health professionals devoted to improving the health, independence and quality of life of all older people. The Society provides leadership to healthcare professionals, policy makers and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information about the American Geriatrics Society CLICK HERE. Dr. Robert Arnold, Keynote Speaker at Fred Hutchinson Cancer Research Center Dr. Robert Arnold, Professor of Medicine and Section Chief of Palliative Care and Medical Ethics at the University of Pittsburgh Medical Center, will be the keynote speaker for The Lynn Murphy Patient and Family-Centered Care Lecture at Fred Hutchinson Cancer Research Center. The lecture, entitled “Ships Passing in the Night: Conflicts between Clinicians and Families” will be Wednesday, June 26th at 4:00pm in the Thomas Building, SZE Conferences rooms with a reception to follow at 5pm. Dr. Arnold formed the Section of Palliative Care and Medical Ethics at the University of Pittsburgh Medical Center, where he is now Chief. In 2000, Dr. Arnold was named the first Leo H. Creip Chair of Patient Care. Dr. Arnold is the Director of the Institute for Doctor-Patient Communication and a Co-Director of the Institute to Enhance Palliative Care. Dr. Arnold has published extensively on ethical issues in end-of-life care, hospice and palliative care, doctor-patient communication, and on ethics education. His current research interests are focused on educational interventions to improve communication in life-limiting illnesses and to understand how ethical precepts are implemented in clinical practice. He has been heavily involved in Oncotalk and Oncotalk-Teach, an evidence-based method to teach oncology fellows communication skills. He recently received funding from the National Palliative Care Research Center, the Arthur Vining Davis Foundation and the Jewish Health Care Foundation to develop a similar program for intensivists regarding critical care communications. Previously Secretary/Treasurer and National Meeting Chair of the American Society for Bioethics and Humanities, he currently serves on the Board of Directors of the American Board of Hospice Medicine. He is also a Past President of the American Academy of Hospice and Palliative Medicine and of the Society for Health and Human Values (in 1996-1997). Please RSVP to attend the lecture to Andrea Chiodo at achiodo@seattlecca.org. NPC Announces the Release of the Third Edition of the Clinical Practice Guidelines for Quality Palliative Care The National Consensus Project (NCP) announces the release of the third edition of the Clinical Practice Guidelines for Quality Palliative Care. Released in March, the 2013 Clinical Practice Guidelines for Quality Care reflect the maturation of the field, health care reform, quality outcomes, and evidenced based palliative care research. This document incorporates important quality assessment and improvement initiatives into palliative care, and describes the comprehensive care necessary for patients at the end of life. The Clinical Guidelines emphasize the patient family centered focus of palliative care, promoting access to palliative care across all patient populations and all health settings. There is expansion of composition and necessary education of the interdisciplinary team beyond chaplaincy, medicine, nursing, pharmacy, and social work to include rehabilitation therapists, respiratory care, and other therapies. The National Consensus Project for Quality Palliative Care is a task force of the National Coalition for Hospice and Palliative Care, a consortium of four national palliative care organizations: the American Academy of Hospice and Palliative Medicine (AAHPM), the Center to Advance Palliative Care (CAPC), the Hospice and Palliative Nurses Association (HPNA), and the National Palliative Care Research Center (NPCRC). Participating members are the Hospice and Palliative Care Organization (NHPCO) and the National Association of Social Work (NASW). The Clinical Practice Guidelines were updated in a collaborative process with representation from the National Consensus Project for Quality Palliative Care members. They have been endorsed by 53 diverse organizations and associations, representing various health care disciplines and community constituents. Detailed information about the NCP is available at www.nationalconsensusproject.org, where the Guidelines can be downloaded free of charge its full‐text version. A free CD may be requested while quantities last. A hard copy may also be ordered. For more information about the Clinical Practice Guidelines or the NCP, contact Amy Killmeyer, at 412/787‐9301 or email amyk@hpnf.org. UW Medicine Magazine features tw o Palliative Care articles UW Medicine Magazine recently featured two articles about Palliative Care and the Palliative Care Center of Excellence. Our Faculty Talk About Palliative Care describes why our leaders became impassioned about Palliative care. The Good Journey describes the importance and development of Palliative Care and why we must teach our future caregivers excellent communication skills. Darrell Ow ens featured in UW Medicine Video UW Medicine has released a video describing the UW Palliative Care Service and featuring Darrell Owens, head of the Harborview Medical Center Outpatient Palliative Care Service. To view the video CLICK HERE. Dr. Randy Curtis presented at the UW Mini -Medical School UW Medicine's 2013 Mini-Medical School is a series of exciting lectures and demonstrations open to the general public and designed to teach you about medical science, patient care and leading-edge research underway at the University of Washington. At Mini-Medical School, UW Medicine experts will discuss what’s new in preventing and reducing the impact of injury, violence and disaster. You will hear about the expanding field of palliative care, examine some of the latest technologies in artificial devices, learn about new innovations and treatments for babies with special needs, and how to keep our young athletes safe and healthy. Researchers have made incredible strides toward understanding, controlling and managing the complex condition of Multiple Sclerosis. Doctor J. Randall Curtis discusses measuring and improving communication about palliative care and end of life care. To view the video CLICK HERE. UW Palliative Care Center discussed on PC Netw orking Call A presentation on the University of Washington Palliative Care Center of Excellence was the focus of WSHPCO’s Palliative Care Networking Call in May. The calls are held on the third Tuesday of each month from 7:30 to 8:30 a.m. under the sponsorship of the Palliative Care Committee. Dr. J. Randall Curtis, one of the directors of the Palliative Care Center with Dr. Anthony Back, explained the center has been designated as one of the key programs of the UW Medicine. Its focus is on patient-centered care for patients with serious illness and on research and education. Both Curtis and Back are professors of medicine at the UW and national leaders in palliative care. Curtis emphasized that end-of-life care is part of palliative care, but palliative care is much broader. The UW Palliative Care Center website includes a definition of palliative care that is worth noting for its inclusiveness: “Palliative care is specialized medical care for people with serious illnesses, focusing on providing patients with relief from the symptoms, pain, and stress of a serious illness, whatever the diagnosis. The goal of palliative care is to improve quality of life for both patients and families provided by a team of doctors, nurses, and other specialists working with a patient's other doctors to provide an extra layer of support. Palliative care is appropriate at any age and at any stage in a serious illness, and can be provided together with curative treatment.” Contributing to the networking call was Helene Starks, who discussed the preliminary work going on to develop metrics around measuring palliative care process and outcome. She is a director with the UW Analysis and Informatics Core. For more information on the UW Palliative Care Center see their website: http:// www.uwpalliativecarecenter.com For information on the Palliative Care Networking calls contact Lisa Butler, lisab@wshpco.org Dr. Tony Back honored by Seattle Business Magazine Dr. Tony Back, Co-Director for the UW Palliative Care Center of Excellence was recently named a 2013 Leader in Healthcare, Outstanding Healthcare Practitioner by Seattle Business Magazine. For details on the award CLICK HERE. “How Has a Personal Experience With Palliative Care Affected Your Professional Outlook?” ONS Connect, the Official Magazine of the Oncology Nursing Society recently feature UW Palliative Care Center of Excellence Member, Simone Javaher, in an article about personal experiences of clinicians with palliative care. To read the complete article CLICK HERE. What’s a “Good Death”? Three Interview s on NPR w ith Dr. Jim deMaine Recently I was interviewed on the local NPR radio station (KUOW) by producer Katy Sewall. In the first of a three part interview Katy started out by asking me to describe a "good death". Candidly, I had to struggle a bit with the answer, because "good" can mean different things to different people. Basically it seems to me that if we, as medical providers, can adhere to the patient's wishes then they can pass from this world in a way that respects and dignifies them as a person. If interested, here is the podcast of the interview (it begins about 12 minutes into this Podcast and lasts for about 17 minutes: http://www.kuow.org/post/week-olympia-what -makes-good-death-and-onlies A second portion of the podcast interview which is more focused on medical interventions is available. It starts about 27 minutes into the segment: http://kuow.org/post/return-787-ancientmaya-and-end-life The third portion deals with "Religion and the Doctor" - one of my blog posts. It starts about 27 minutes into the podcast: http://kuow.org/post/olympia-actress-kate-hess-and-doctors-viewdeath - Dr. Jim deMaine PCCE Members Bibliography *Articles listed are 2013 publications in peer-reviewed journals. If you have an article you would like to have featured, please email pallcntr@uw.edu. Cox-North, P., Doorenbos, A., Shannon, S.,Scott, J., & Curtis, J.R. The Transition to End-of Life Care in End-Stage Liver Disease. Journal of Hospice & Palliative Nursing. 15(4):209-215, June 2013. Demiris G, Parker Oliver D, Kruse RL, Wittenberg-Lyles E. Telehealth group interactions in the hospice setting: assessing technical quality across platforms. Telemed J E Health. 2013;19 (4):235-40. Hill N, Schraufnagel D, Curtis JR. Why PATS to AnnalsATS? (editorial) Proceedings of the American Thoracic Society 2013; 10:53. Mauksch L, Farber S, Greer HT, Design, Disemination, and Evaluation of and Advanced Communication Elective at Seven US Medical Schools, Academic Medicine, 2013;88(6): 843-851. Reece J, Chan YF, Herbert J, Gralow J, Fann JR. Course of depression, mental health service use, and treatment preferences in women receiving chemotherapy for breast cancer. General Hospital Psychiatry. May 1, 2013 [Epub ahead of print] If you have questions, comments or would like to be removed from our mailing list, email us at pallcntr@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER A Message from the Director March 2013 Since the last newsletter, the Palliative Care Center of Excellence has been working on identifying and defining the objectives and accompanying tasks that each of our three operational areas (e.g., clinical, educational, research) will undertake. As we finalize these objectives and tasks, we look forward to sharing these plans with the PCCE membership with the goal of obtaining your feedback and recommendations. The following provides a brief summary of each of the operational areas objectives and tasks to date: Clinical operations: In order to advance our goals for the clinical operations, we have developed a Palliative Care Clinical Strategic Planning Committee charged by Dr. Paul Ramsey, who is CEO of UW Medicine, Dean of the School of Medicine, and Vice President for Medical Affairs of UW. His charge includes developing a strategy for enhancing and integrating palliative care at all UW Medicine sites. This Committee has developed standards for palliative care services – both inpatient and outpatient – and is working with the leadership at each UW Medicine site to ensure that palliative care meets or exceeds the standards. In addition, we are in the process of developing quality metrics that will be shared across all sites to document our progress and identify ways to improve the care we provide. Educational operations: The education operations of the PCCE is focusing on identifying current curricula in palliative care for undergraduate, graduate and post-graduate educational programs across the Health Sciences schools. This review of educational programs is a first step towards strengthening and integrating these curricula. We are also working to identify opportunities to enhance inter-professional education in palliative care across these programs. Research operations: The research operations has identified a number of opportunities for enhancing palliative care research at UW: 1) the development of a research seminar series to present completed palliative care research to the broader UW community; and 2) a “research works-in-progress” seminar for the presentation and feedback about research that is under development or in the early phases of implementation. We will publicize these opportunities through our PCCE membership list as well as on our website. www.uwpalliativecarecenter.org New sletter Spotlight Membership– Sign up now! The Palliative Care Center of Excellence has developed a membership structure. Membership is free to those interested in being involved in or supporting the PCCE. All you need to do is sign up on the website: the weblink is provided below. Benefits of membership include regular updates and the quarterly newsletter. Members will also have access to PCCE resources including the Informatics and Analysis Core and will be eligible to apply for the small pilot grants program once it begins. www.uwpalliativecarecenter.c om/membership.html We now offer membership to the PCCE that allows us to identify who we are and increases our ability to get resources and opportunities in palliative care to our members. We currently have 90 members, who represent a diverse group of individuals. Our current members are distributed as follows: 5% chaplain/spiritual care providers, 4% educators, 4% healthcare administrators, 17% nurses and nurse practitioners, 27% physicians, 17% researchers/scientists, 16% social workers, and 10% other disciplines. In response to a survey question regarding the primary activity each member does were as follows: 33% research, 39% clinical work, 14% educational activities, and 35% administration. Membership is open to all (and free!) so if you are interested in membership, go to our website for the membership form. The PCCE is also launching a community outreach program to solicit feedback from the regional communities regarding important areas of focus for the PCCE. We will hold two Community Forums in April. The primary audience for these events is the members of the communities that we serve; however PCCE members are welcome to come. We would also encourage you to extend an invitation to others you know who would be interested in attending. Details below and on our website: www.uwpalliativecarecenter.com. As always, we welcome your suggestions and feedback. Please contact us if you have comments or if you would like to be more involved. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine The Palliative Care Center hosts a Community Forum The Palliative Care Center of Excellence will hold its first Community Forum in April. The purpose of this forum is to invite community members to share their experiences around palliative care and to think if ways the PCCE can be influential in future experiences involving palliative care. The Forum will also serve to recruit members for the PCCE Community Advisory Board. The goal of the Community Advisory Board is to provide advice, input, and support for the Palliative Care Center of Excellence to help ensure that the Center meets its mission of improving the lives of patients with serious illness and their families. The Community Advisory Board is comprised of volunteer community members who faced serious or terminal illness personally or through a family member or loved one, so that they may bring their experiential perspective to advise the leaders and members of the Palliative Care Center of Excellence. There will be two Community Forums to choose from. Saturday, April 27th from 2pm-4pm at he UW Center for Urban Horticulture and Monday, April 29th from 6pm-8pm at the Dumas Bay Centre in Federal Way. Everyone is welcome! If you or someone you know would be interested in participating, please attend. For more information and to RSVP, email Jimmy Hoard at jthoard@uw.edu. Committee on Transfor ming End -of-Life Care: First Meeting The IOM Committee on Transforming End-of-Life Care will hold its first meeting on February 20th and 21st at the National Academy of Sciences building located at 2101 Constitution Avenue N.W., in Washington, D.C. There was a public session from 1:00 p.m. to 5:00 p.m. on February 20. The agenda featured discussion of the committee’s scope of work and previous Institute of Medicine reports that addressed end-of-life care. There will also be an opportunity for public comments on issues that the committee will address in its work. For more information, click HERE. HMC Outpatient Pri mary Palliative and Supportive Care Program I mpacting ED Usage and Hospital Admission Rates The Harborview Primary Palliative and Supportive Care Clinic recently completed a longitudinal study to explore the impact of combined primary and palliative care on healthcare utilization by patients with a life-limiting illness. Chart reviews were conducted on a convenience sample of 146 patients cared for by a primary palliative care clinic between July 1, 2010 and June 30, 2011. Healthcare utilization after enrolling with the clinic was compared to utilization in the 12 months prior to the date of enrollment. Statistical analyses estimated a 28.6% reduction in emergency visits after enrollment (95%CI: 0.9%-48.5%, p=0.0437) and a 20.2% reduction in hospital admissions (95%CI: -0.7%-36.8%, p=0.0576). These findings suggest that combined primary and palliative care can decrease utilization of healthcare services by individuals with lifelimiting conditions. The Program current serves just under 300 patients, the majority of which are seen in a nonclinic setting (home, nursing home, assisted living facility or adult family home). While the program operates from Harborview, referrals are accepted from any UW or community facility. Approximately 50% of referrals over the past year have originated from outside the UW Medicine Health System. Committee on Transfor ming End -of-Life Care: First Meeting The 4th Annual Ethics in Health Care: Perspectives and Applications Symposium will take place on Wednesday, May 8, 2013 from 8:30am—12:00pm at Virginia Mason Medical Center in the Volney Richmond Auditorium. This year’s topic, which is co-sponsored by Group Health and Virginia Mason, will be about stewardship and autonomy. Please save the date! Questions? Please contact Shannon Callin at callin.s@ghc.org UW Medicine CONSULT: In Grave Moments Come Insights about Life Choices The following is an excerpt from an article that appears in the Winter 2013 UW CONSULT Newsletter: Medical advances today keep patients alive through diseases and traumas that a generation ago meant certain death. Such progress enables people with life-threatening illnesses to more fully consider not only “How will I die?” but also “How will I live?” The thought can seem emancipating or onerous, depending on the health conditions involved, a person’s outlook and myriad other considerations of daily life. At UW Medicine, palliative care specialists help patients and families acknowledge mortality and then explore living with intention. To see the full article, please click here. 11th Annual Harborview Palliative Care Conference Registration is open for the 11th Annual Palliative Care Conference on Tuesday, April 30th at Harborview Medical Center. This conference is sponsored by the Harborview Medical Center Palliative Care Committee, with the goal of exploring a variety of topics related to palliative care, end of life care, death and bereavement. It is a multidisciplinary conference and is appropriate for any staff that support and/or work with these patients and families. The conference is free to all HMC employees and at a reduced charge to UWMC, ALNW, Northwest Hospital and Valley Medical employees. CEU’s are approved only for nurses at this time but other participants will receive a certificate of participation. For more information, including how to register, click HERE. April – A Time to Talk, A Time to Plan The 6th Annual National Healthcare Decisions Day is scheduled for April 16, 2013 with the goal of educating and empowering the public and providers about the importance of advance care planning. Enter the Conversation Project, a grassroots public campaign designed to change the way the country wrestles with end of life. The Conversation Project encourages people to have honest and open discussions with their loved ones at “the kitchen table” about what is important to them and how they would want to spend their final days. Providence Hospice of Seattle will spearhead a number of activities throughout the month of April to acknowledge National Health Care Decision day and engage the public in the “conversation”. Activities planned include: Several evening and lunchtime talks on advanced planning, utilizing different planning tools (such as the 5 Wishes) Conversation coaching on how to start the end-of-life discussion (s) A panel discussion following a viewing of “In My Time of Dying” Kiosks set up at local hospitals and health care facilities promoting the Conversation Project and advanced planning Providence Hospice employees sharing their story on the Conversation Project’s interactive website Encouraging health care professionals and the public at large to share their story on www.theconversationproject.org Providence is also seeking interested MDs/providers to talk with other professionals in April about the POLST and the importance of advanced planning. If interested, please contact Stephanie Mehl, RN, MS at Providence Hospice of Seattle. She can be reached at 206 694 9335 or at stepanie.mehl@providence.org. Update from the Educational Operations of the PCCE This is an exciting time in the field of palliative care. What was once a specialty practiced on the fringes of medicine and mostly at the end of life, is now an integral part of patient centered care. How we train and educate healthcare professionals under this new model is in constant evolution. We are thrilled to be part of the movement taking shape. From within the UW system and working with our broader regional community partners, the Educational Operations of the PCCE hopes to serve as a central place to share ideas, combine resources, and unite our efforts to deliver high quality, collaborative, and comprehensive palliative care training across all disciplines. The necessity of palliative care is being widely embraced, yet the demand for qualified providers is quickly outpacing current training capabilities. Some in palliative care say,” we have done our job when we put ourselves out of work”. Meaning that every health professional should be capable of providing basic primary palliative care services. This strategy, considered “raising the floor,” allows greater penetration of palliative care with fewer resources. By providing all health professionals with basic skills we assure some degree of access to all patients and families. How to achieve this aim will be one of the primary areas of focus for the Educational Operations of the PCCE. The next area of focus will be on providing more extensive services to patients facing serious illnesses such as cancer or other terminal illnesses. Professionals caring for their patients need targeted and in depth instruction in palliative care. Lastly, patients with the most complicated palliative care needs and symptom management will require qualified palliative care specialists with comprehensive training. A central tenet in palliative care is the interdisciplinary team model and we hope that all our educational efforts will reflect this guiding principle. Integrating interprofessional education across disciplines in creative ways will be fundamental to the mission of delivering high quality palliative care to all patients and families. The additional challenge we face is working across all levels of education from undergraduate on up through the post graduate years. We are excited to think about shaping these learning opportunities. Since our community is rich with innovative thinkers and the demands are great, we need your help. We are looking to form a “Community of Educators”, from all disciplines, who want to mold the future of palliative care training, building on many of the great efforts already taking place. Our focus will encompass three main domains. A) Trainee education (pre-licensure, post-licensure and advanced practice), B) Current UW providers, and C) The greater NW community. Activities may include curriculum development, inter-professional education events, certification courses, continuing education retreats and conference organization, onboarding programs and mentorship. If you want to be involved, please contact our administrator Jimmy Hoard at jthoard@uw.edu and we will include in future development sessions. Sincerely, Sarah Shannon PhD, RN and Caroline Hurd, MD Co-Chairs of Educational Operations Palliative Care Center of Excellence IWG Conference: Hospice and Palliative Care, Grief Counseling and the Aftermath of Trauma and Disaster April 27th at the Inn at Laurel Point, Victoria, BC This conference is a day-long, multi-track event, focused on current thinking and practice in responding to the needs of the dying, the bereaved, and those struggling in the wake of violent death and disaster. This conference is intended for all who work in hospice and palliative care, grief counseling, funeral service, disaster response, pastoral care, and public health. The conference will take place at the Inn at Laurel Point, Victoria, BC. If you require accommodation at the hotel, preferred rates have been established for conference attendees. To reserve a room, please call 250.386.8721 or 1.800.663.7667, quoting ‘International Working Group 2013′. For further details on the conference visit the website by clicking HERE. PCCE Members Bibliography *Articles listed are 2012-13 publications in peer-reviewed journals. If you have an article you would like to have featured, please email jthoard@uw.edu. Clark, JD & DM Dudzinski. 2013. The culture of dysthanasia: attempting CPR in terminally ill children. Pediatrics. originally published online February 4, 2013. DOI:10.1542/peds.20120393. Curtis JR, Downey L, Engelberg RA. The Quality of Dying and Death: Is it ready for use as an outcome measure? (editorial) Chest 2013; 143:289-291. Davies PS, Prince-Paul M. Palliative care in the outpatient cancer center. J Hosp Pall Nurs. 201; 14(8):506-13. Kross EK, Curtis JR, Cooke CR. Whom should we rely on when assessing symptoms of critically ill patients? (editorial) Crit Care Med. 2012; 40:2899-900 . Kruse RL, Parker Oliver D, Wittenberg-Lyles E, Demiris G. Conducting the ACTIVE randomized trial in hospice care: Keys to success. Clin Trials. 2013;10(1):160-9. Kundu, A., Dolan-Oves, R., Dimmers, M. A., Towle, C. B., & Doorenbos, A. Z. (2013). Reiki training for caregivers of hospitalized pediatric patients: A pilot program. Complementary Therapies in Clinical Practice, 13, 50-54. O'Hare AM, Vig EK, Hebert PL. Initiation of Dialysis at Higher Levels of Estimated GFR and Subsequent Withdrawal. Clin J Am Soc Nephrol. 2013 Feb;8(2):179-81. Reinke LF, Uman J, Udris EM, Moss BR, Au DH. Preferences for death and dying among veterans with chronic obstructive pulmonary disease. Am J Hosp Palliat Care. 2013 Jan 8. Washington KT, Wittenberg-Lyles E, Parker Oliver D, Demiris G, Shaunfield S, Crumb E. Application of the VALUE Communication Principles in ACTIVE Hospice Team Meetings. J Palliat Med. 2013;16(1):60-6. If you have questions, comments or would like to be removed from our mailing list, email us at jthoard@uw.edu. Visit our website at: www.uwpalliativecarecenter.com PCCE NEWSLETTER Welcome from the Director The Palliative Care Center of Excellence was officially launched this fall with two well-attended activities presented to the UW community. The first, Medical Grand Rounds, described the rationale and plans for the launch of the Center. Dr. Back and I, Directors for the Center, made the presentation -which is available currently on YouTube (see link on the PCCE website: www.uwpalliativecarecenter.com). The second, an inaugural visiting professor lecture by Dr. Susan Block from Harvard Medical School and the Dana Farber Cancer Institute, described a checklist approach designed to move discussions about, and provision of, palliative care upstream from end of life. Since our launch, we have identified leadership for each of the three Operations groups of the Center – Clinical, Research, and Education. Dr. Stu Farber is the leader for the Clinical Operations, with leadership support by Wayne McCormick, Darrell Owens, and Elizabeth Loggers. Drs. Ruth Engelberg and Ardith Doorenbos are heading Research Operations and Drs. Sarah Shannon and Caroline Hurd are providing leadership for Education Operations. We are currently finalizing plans for all three Operations groups, including the specific tasks and timelines each Operations group will undertake. Once these drafts are developed, we will share them with the PCCE membership for your feedback. As part of the Clinical Operations, the Center has supported the development of a Palliative Care Clinical Strategic Planning Committee. This Committee, chaired by Cindy Hecker and me, was charged by Dr. Paul Ramsey – the Dean of the School of Medicine and the CEO of UW Medicine – to develop and deploy a strategic vision for the delivery of palliative care services across the UW Medicine health system. The Committee is planning to present this vision to the UW Medicine leadership in the next month. The PCCE is also in the process of developing a Community Advisory Board that will provide input from patients, family members and the broader Seattle and WWAMI communities. The charge of this Community Advisory Board is to ensure that we focus our energies and resources in ways that maximize our ability to meet our mission to advance palliative care and serve the needs of patients and their families. We welcome suggestions and feedback from the PCCE community. Please contact us if you have comments or if you would like to be more involved. J. Randall Curtis, MD, MPH Director, UW Palliative Care Center of Excellence A. Bruce Montgomery – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine Dece mber 2012 www.uwpalliativecarecenter.org New sletter Spotlight Dr. J. Randall Curtis, was named as the first holder of the A. Bruce MontgomeryAmerican Lung Association Endowed Chair in Pulmonary and Critical Care Medicine at the Inaugural Lecture of the Palliative Care Center of Excellence on October 8th. Membership– Coming Soon! The Palliative Care Center of Excellence will be developing a membership structure. Membership will be free to those interested in being involved in or supporting the PCCE. All you need to do is sign up on the website: the web signup will be available soon. Benefits of membership will include regular updates and the quarterly newsletter. Members will also have access to PCCE resources including the Informatics and Analysis Core and will be eligible to apply for the small pilot grants program once it begins. Stay tuned for more information on how to become a member. Darrell Ow ens receives Cambia Sojourn Aw ard Darrell Owens, DNP MSN is the recipient of the Cambia Sojourns Award for leadership and excellence in Palliative Care. Darrell Owens is the founder of the Palliative Care Service at Harborview Medical Center. He is the current Director of Outpatient Palliative Care Services. He holds a BS in Nursing from Emory University, an MS in Health Services Administration from St. Mary's College of California, an MS in Nursing from Seattle Pacific University, and a Doctor of Nursing Practice from the University of Alabama at Birmingham. He is also a post-doctoral graduate of the Harvard Medical School's Faculty Scholar in Palliative Care Program. His an advanced registered nurse practitioner with board certifications in Adult Health/Primary Care, Geriatrics, and Hospice and Palliative Care. Dr. Owens has over 20 years experience in hospice and palliative care, having served in a variety of roles from staff nurse to administrator. He is an internationally known author and speaker, having published over 20 review and research articles, a reference book on the provision of palliative care for people with liver disease, and a chapter on palliative care in the 3rd edition of the Fundamentals of Disaster Management. He is also the founder of the Primary Palliative Care Clinic, the first, and only nurse practitioner directed clinic in the United States that provides both palliative and primary care patients with a life-limiting illness. Northw est Hospital names Palliative Care Program Manager Northwest Hospital’s new Palliative Care Consult Service will launch limited operations in January 2013, with full operations following on February 1, 2013. Katie Poinier, RN, BSN, the current Charge RN and Case Manager for the HMC Outpatient Palliative and Supportive Care Clinic will be the new Program Manager. The Palliative Care Center of Excellence leadership is excited to welcome Katie and looks forward to the launch of the new Northwest Hospital Palliative Care Service. Attending providers for the service include Darrell Owens, DNP who will also serve as the Administrative Director, Jim Gordon, MD who will serve as the Medical Director, and Megan Morrison, ARNP. PCCE Members Bibliography *Articles listed are 2012 publications in peer-reviewed journals. If you have an article you would like to have featured, please email jthoard@uw.edu. Artherholt SB, Fann JR. Psychosocial care in cancer. Curr Psychiatry Rep 14:23-29, 2012 Au DH, Udris EM, Engelberg RA, Diehr PH, Bryson CL, Reinke LF, Curtis JR. A randomized trial to improve communication about end-of-life care among patients with COPD. Chest 2012; 141:726-735. Bombardier CH, Fann JR, Tate D, Richards JS, Wilson CS, Warren AM, Temkin NR, Heinemann AW. An exploration of modifiable risk factors for depression after spinal cord injury: Which factors should we target? Arch Phys Med Rehabil 93:775-781, 2012 Bombardier CH, Kalpakjian C, Graves D, Dyer D, Tate D, Fann JR. Validity of the Patient Health Questionnaire-9 in assessing major depressive disorder during inpatient spinal cord injury rehabilitation. Arch Phys Med Rehabil 93:1838-1845, 2012 Creutzfeldt CJ, Holloway RG. Treatment decisions after severe stroke: uncertainty and biases. Stroke. 2012 Dec;43(12):3405-8. doi: 10.1161/STROKEAHA.112.673376. Epub 2012 Nov 13. No abstract available. Creutzfeldt CJ. Reflections: neurology and the humanities. Not just yet. Neurology. 2012 Jul 10;79(2):197. Creutzfeldt CJ, Holloway RG, Walker M. Symptomatic and palliative care for stroke survivors. J Gen Intern Med. 2012 Jul;27(7):853-60. Curtis JR, Engelberg RA, Bensink ME, Ramsey SD. End-of-Life Care in the Intensive Care Unit: Can We Simultaneously Increase Quality and Reduce Costs? Am J Respir Crit Care Med. 2012 Oct 1;186(7):587-92 Curtis JR, Ciechanowski PS, Downey L, Gold J, Nielsen EL, Shannon SE, Treece PD, Young JP, Engelberg RA. Development and evaluation of an interprofessional communication intervention to improve family outcomes in the ICU. Contemp Clin Trials. 2012 Nov;33(6):1245-54. Davies PS, Prince-Paul M. Palliative Care in the Outpatient Cancer Center: Current Trends. J Hosp Pall Nurs, 2012 Dec; 14(8):506–513 Demiris G, Parker Oliver D, Wittenberg-Lyles E, Washington K, Doorenbos A, Rue T, Berry D. A noninferiority trial of a problem-solving intervention for hospice caregivers: in person versus videophone. J Palliat Med. 2012;15(6):653-60. Dickson RP, Engelberg RA, Back AL, Ford DW, Curtis JR. Internal medicine trainee selfassessments of end-of-life communication skills do not predict assessments of patients, families or clinician-evaluators. Journal of Palliative Medicine 2012; 15:418-426. Doorenbos, A. Z., Lindhorst, T., Starks, H., Aisenberg, E., Curtis, J. R., & Hays, R. (2012). Palliative care in the pediatric ICU: Challenges and opportunities for family centered practice. Journal of Social Work in End-of-Life and Palliative Care, 8, 297-315. Fann JR, Ell K, Sharpe M. Integrating psychosocial care into cancer services. J Clin Oncol 30:1178-1186, 2012 Ford DW, Downey L, Engelberg RA, Back AL, Curtis JR. Discussing religion and spirituality is an advanced communication skill: An exploratory structural equation model of physician trainee self-ratings. Journal of Palliative Medicine 2012; 15:63-70. Haozous E, Doorenbos AZ, Demiris G, Eaton LH, Towle C, Kundu A, Buchwald D. Role of telehealth/videoconferencing in managing cancer pain in rural American Indian communities. Psychooncology. 2012;21(2):219-23. Jensen MP, Gralow JR, Braden A, Gertz KJ, Fann JR, Syrjala KL. Hypnosis for symptom management in women with breast cancer: A pilot study. International J Clin Exper Hypnosis 60:135-159, 2012 Kross EK, Nielsen EL, Curtis JR, Engelberg RA. Survey burden for family members surveyed about end-of-life care in the intensive care unit. Journal of Pain and Symptom Management 2012; 44:671-680. (PMID: 22762964) Oliver DP, Demiris G, Wittenberg-Lyles E, Washington K, Day T, Novak H. A systematic review of the evidence base for telehospice. Telemed J E Health. 2012;18(1):38-47. Osborn TR, Curtis JR, Nielsen EL, Back AL, Shannon SE, Engelberg RA. Identifying elements of ICU care that families feport as important but unsatisfactory: Decision-making, control and ICU atmosphere. Chest 2012; 142:1185-1192. Owens, D, Eby, K, Burson, S, Green, M, McGoodwin, W, Isaac, M. Primary Palliative Care Clinic Pilot Project demonstrates benefits of a nurse practitioner directed clinic providing primary and palliative care. Journal of the American Academy of Nurse Practitioners, January 2012. Owens, D. The Role of Palliative Care in Trauma. Critical Care Nursing Quarterly. 35(3): 223227; July 2012. Parker Oliver D, Washington K, Demiris G, Wittenberg-Lyles E, Novak H. Problem solving interventions: an opportunity for hospice social workers to better meet caregiver needs. J Soc Work End Life Palliat Care. 2012;8(1):3-9. Rockhill CM, Jaffe K, Zhou C, Fan MY, Katon WJ, Fann JR. Health care costs associated with traumatic brain injury and psychiatric illness in adults. J Neurotrauma 29:1038-1046, 2012 Rosenberg, AR. How They Do This. J Clin Onc published online on September 24, 2012; DOI:10.1200/JCO.2012.45.8752. Washington KT, Demiris G, Parker Oliver D, Wittenberg-Lyles E, Crumb E. Qualitative Evaluation of a Problem Solving Intervention for Informal Hospice Caregivers. Palliat Med. 2012; 26 (8):1018-1024. Wittenberg-Lyles E, Goldsmith J, Oliver DP, Demiris G, Rankin A. Targeting communication interventions to decrease caregiver burden. Semin Oncol Nurs. 2012;28(4):262-70. Wittenberg-Lyles E, Demiris G, Parker Oliver D, Washington K, Burt S, Shaunfield S. Stress variances among informal hospice caregivers. Qual Health Res. 2012;22(8):1114-25. Wittenberg-Lyles E, Debra PO, Demiris G, Rankin A, Shaunfield S, Kruse RL. Conveying empathy to hospice family caregivers: Team responses to caregiver empathic communication. Patient Educ Couns. 2012;89(1):31-7. Wittenberg-Lyles E, Goldsmith J, Demiris G, Oliver DP, Stone J. The Impact of Family Communication Patterns on Hospice Family Caregivers: A New Typology. J Hosp Palliat Nurs. 2012;14(1):25-33. Wittenberg-Lyles E, Shaunfield S, Oliver DP, Demiris G, Schneider G. Assessing the readiness of hospice volunteers to utilize technology. Am J Hosp Palliat Care. 2012;29(6):476-82. Wong SP, Kreuter W, O'Hare AM. Treatment intensity at the end of life in older adults receiving long-term dialysis. Archives of Internal Medicine 2012 Apr 23; 172 (8) 661-3. Wu D, Virtual Grief, JAMA. 2012;308(20):2095-2096 If you have questions, comments or would like to be removed from our mailing list, email us at jthoard@uw.edu Visit our website at: www.uwpalliativecarecenter.org