A better way to go: improving utilization of palliative care through patient, family, caregiver and provider engagement

Purpose Palliative Care is specialized medical care for patients with serious illnesses that can be provided concurrent with other treatment and cure-oriented therapies. Integration of palliative care early in the trajectory of illness enhances the well-being of patients, families and caregivers. Despite widespread acceptance of its value, palliative care remains an underutilized resource commonly introduced late in the course of serious illness, if at all. Knowledge deficits about palliative care exist among patients, families, caregivers, and clinicians. Research demonstrates that provision of information about palliative care to patients, families, caregivers, and members of the public results in increased understanding and a favorable opinion about palliative care. Physicians are identified as the most difficult group to influence, indicating the importance of increasing pressure from the demand side by patients, families, and caregivers, for palliative care utilization to improve. Methodology This project examined the effect of provision of customized palliative care toolkits on rates of referral to palliative care (by primary care providers) and self-assessed knowledge about palliative care (by patients, families and caregivers in a small-group setting). Referrals to palliative care by primary care providers (APN's, MD's, DO's, and PA's) were assessed through electronic health record entries for a three-month period of time before and after distribution of a multi-media tool kit via email. Self-assessed knowledge of palliative care among residents of a continuing care facility was assessed before and after a small-group meeting where palliative care information and a tool-kit were distributed. Volunteer Palliative Care Ambassadors were recruited. Results Referrals to palliative care by providers were not significantly affected (p=.29). Knowledge about palliative care increased significantly in the small-group participants (p=.0005). The Palliative Care Ambassadors (n=3) did not continue participation in the project. Implications for Practice Increasing knowledge about palliative care among members of the public is possible. Increasing referrals to palliative care by clinicians is difficult. Improving utilization of palliative care may need to be accomplished through patient, family, and caregiver engagement in the referral process.DNPIncludes bibliographical reference