Palliative care providers in several states are finding the best way to connect to the community is through pre-existing, and in some cases, non-medical community groups.
Sarah Kivett, director of strategic partnerships at Hospice & Palliative Care of Iredell County in North Carolina, said her organization has grown from 80 palliative care patients since its origination in 1984 to about 480 today. Kivett attributes much of that growth to collaboration with a local hospital.
“We worked with them and put an inpatient palliative care provider in the hospital as well as an RN liaison. But we also work very closely with our local [Accountable Care Organization (ACO)] in trying to care for patients with serious illness on up the trajectory to decrease hospital encounters and improve quality of life,” she told Palliative Care News.
In California, a collaboration between Stanford Medical Center and several community organizations has been in development since before the pandemic lockdown.
About four years ago, an anonymous donor gave enough money to Stanford to support efforts to promote palliative care within the community. At first, the endeavor centered on education, spreading the word about what palliative care is and why it is important.
“In the process of our work, we realized that with our marketing, we could only reach a certain population,” Dr. Grant Smith, medical director of the Stanford Palliative Care Center of Excellence (PCCOE) Community Partnerships Team, said. “And so, we wanted to go outside of Stanford to try to work with other community-based organizations to reach a broader population.”
The Stanford efforts have focused on two specific local groups, Bay Area Cancer Connections and Cancer Care Point — both focused on patients living with cancer.
“In some of our future work we’re hoping to partner with other organizations that might already have expertise in populations that traditionally don’t access or [are] underserved in palliative care and hospice,” Smith said.
At the Hospice of Acadiana Inc. in Lafayette, Louisiana, community partnerships have been part of the fabric for the duration of its 40-year existence. Developing and maintaining those collaborations is key to success, according to Hospice of Acadiana CEO Keith Everett.
“We’re actually developing some keen partnerships from a volunteer perspective to ensure that we’re getting awareness and communication out about hospice and palliative medicine across the community,” Everett told Palliative Care News.
Having a close connection within a community can make palliative care more accessible. In North Carolina, Kivett said her group is the eyes and ears of the health care team within a patient’s home, outside of visits with a primary care physician.
A caregiver can see obstacles to a patient’s health journey that might not be obvious during an office visit. For example, if there is a problem with transportation or taking medication, a palliative care provider working in the home can identify that issue and address it, she said.
“A lot of times, there’s social determinants of health and being able to carry through,” Kivett said. ” “And so that takes them back to the emergency room if they’re not able to get their medicines. And we work very hard to be that resource in the family home that a primary care physician is not able to see.”
Everett’s organization specifically targets those social determinants of health in their work with local groups.
Hospice of Acadiana is developing ways to collect data on social determinants of health, determining what factors in a patient’s life generate stress, hindering their path to health. That information will be shared with one of the organization’s community partners, Beacon, which can help address those stresses.
“We can then expand this model beyond the patient to include caregivers,” Everett said.
In his experience in California, Smith has seen a common theme — people are not totally clear on what palliative care is. Collaborating with local groups should help educate and alleviate that lack of understanding.
“I think that’s one thing that we found is that when we go out to ask community partners, there’s a real openness and desire to know more about what palliative care is,” said Smith. “I think some people maybe have heard of palliative care, but there is not a lot of understanding or maybe some misperceptions or misconceptions about what palliative care is.”
Ultimately, collaborations between palliative care providers and local community organizations will be judged on their success. Smith defines success as a very clear, collegial relationship that advances patient care.
“I hope that we can have that relationship where we’re sort of there to help troubleshoot whatever we can offer,” he said. “From our clinical expertise of knowing palliative care and hospice and how the medical system works, we can be that resource for them.”
Kivett said she believes the role of her organization is clear: Enhancing the relationship between a patient and their primary care provider, not trying to replace that relationship.
“We are just here as an added resource to maximize the quality that we can give them,” she said. “These are people that we go to church with. These are people that we see in the grocery store. We want to make sure that they’re out and about as much as they can, as often as they can. So I think that is our goal, and I think that meeting that part of our mission and taking that part very seriously has contributed to the growth that we’ve had.”
Everett also sees a holistic definition of success as the goal for his organization’s efforts.
“Success can be defined as offering services not only to patients but also extending those services to caregivers provides them support,” Everett said. “This involves establishing an environment that enables them to concentrate on what matters most when navigating their end of life journey.”