Ft. Wayne, Ind.-based hospice provider Visiting Nurse will christen a new palliative care outpatient clinic on the campus of Dupont Hospital in their local area. In addition to symptom management and other palliative services, Visiting Nurse intends for the clinic to improve continuity of care for patients who require palliative care or hospice.
The clinic will facilitate goals-of-care discussions between patients and clinicians as well as advance care planning. Studies show that advance care planning can reduce hospitalizations by as much as 26%, reduce health care costs, increase community-based palliative care and hospice utilization, as well as significantly increase the likelihood that care will be delivered in accordance with the patient’s wishes.
The clinic is designed to serve patients who are suffering from serious, terminal or life-limiting illnesses. Common diagnoses include cancer, congestive heart failure, chronic obstructive pulmonary disease, dementia, HIV/AIDS, and stroke, among others. The hospice and palliative care provider expects that most of the population they will serve at the clinic will consist of geriatric patients.
“[Visiting Nurse] has a home health and hospice division. If a patient has a need for that level of service — and should the patient and their family choose our agency — it would help with the continuity of care. One of my biggest frustrations when I started out as a fellowship-trained geriatrician in private practice was continuity of care and being able to participate in my patients’ care decisions across every level of care,” said Ann Moore, D.O., chief medical officer for Visiting Nurse. “This does give an opportunity for patients, should they wish to have that continuity of care, to receive service all the way across the continuum. We can establish that rapport and relationship with patients prior to their becoming hospice appropriate, so it’s a little more comfortable for them.”
Hospices nationwide have been seeking ways to work with patients earlier in their disease trajectory. Many patients enter hospice too late for them to receive the full benefits. More than 27% of patients in 2017 were in hospice for seven or fewer days, with another 12.7% in hospice for fewer than 14 days, according to the National Hospice & Palliative Care Organization.
Patients can receive concurrent curative care while receiving services at the Visiting Nurse clinic, which will be staffed by physicians and nurse practitioners.
The new palliative clinic will come onto the scene with built-in referral sources from Dupont Hospital and affiliated organizations. Dupont Hospital is among the few hospitals in the United States that feature a certified geriatric emergency department. Dupont has forged a relationship with a local practice, Ft. Wayne Medical Oncology and Hematology, which is in the process of opening its own outpatient clinic on the hospital’s campus.
“[Opening on the Dupont campus] is a nice marriage between their program with the geriatric population, supporting people out in the community, and our agency’s skill set and expertise. In addition to the geriatric focus, Dupont Hospital had entered into a partnership with Fort Wayne Medical Oncology and Hematology, a local independent group, to establish an oncology clinic,” Moore told Hospice News. “We are located just a few suites over. We have been in conversation with them over the past several months as we were trying to gauge the need for this service.”