Patients at the Northeast Georgia Medical Center can now take advantage of a new palliative care program that brings the care from the clinic or hospital into the patient’s home.
The center, which covers 14 counties in the northeast corner of the state, began offering the in-home palliative care program during the COVID-19 pandemic. Earlier this year, the hospital revamped and reworked the program and subsequently earned Community Health Accreditation Partner (CHAP) accreditation.
Dr. Leena Dutta, medical director of hospice and in-home palliative care for the center, joined the program in May, 2022 and oversaw the initiative.
“That’s when we started to revamp the program. Look at what we were trying to do, what was our identity. Got everything together, got our policies and procedures together, and that’s when we decided to apply for CHAP certification,” Dutta said.
The home-based palliative care program has its roots in a movement that began about 20 years ago, Dutta said. At that time, hospital staff became interested in providing patients more than just the standard aggressive treatments for illness.
Rather, they wanted to provide clear, understandable information that enabled the patient to make reasonable, informed choices about their care. The palliative care program started with cancer patients, helping them deal with the mental and physical ramifications of their illness.
“When patients got their diagnosis for a cancer, there’s a lot that goes into processing that — there’s a need for social work and for counseling to sort of help them deal with the issues… whether they want treatment, whether they don’t want treatment, how much treatment do they want,” Dutta said.
The palliative care program evolved quickly to include patients outside the oncology department – people with heart failure or emphysema, for example. It then moved from hospital to clinic and, eventually, to include the home-based palliative model that launched during the recent pandemic.
Northeast Georgia’s home-based palliative system started through their hospice operations. According to Dutta, because hospice care is home based and home-focused, it made sense for that group to initiate the in-home palliative care model.
The Northeast Georgia model provides a nurse practitioner, who works under the advice of a physician, and a social worker. Patients can also access chaplain services and complementary therapies such as massage, among others, Dutta said.
This interdisciplinary group meets every two weeks to collect updates on the patient, the care and what the way forward may be with each patient, she said.
Right now, the in-home program has a staff of four full-time nurse practitioners and three part-time nurse practitioners. two full-time social workers, and part-time chaplains and volunteers.
That staff oversees a patient census of 140. The number has been as high as 200 patients, Dutta said. The plan is to continue to grow the patient census.
According to Dutta, the need for in-home palliative care is clear. There are patients who can’t get to the clinic easily, or have multiple doctors overseeing multiple medical conditions, information that needs to be curated and organized to ensure the best care possible. It’s important, Dutta said, that the palliative team be on hand to manage changes in patient condition – whether that erosion or improvement in their prognosis. The aim is for a holistic approach.
“Sometimes, it’s not just about cancer or the lungs or the heart. It’s about the whole picture and the patient. So, we help humanize the care,” Dutta said.
As patients live longer, health care needs increase as well. Dutta expects the in-home palliative care program to continue to expand and grow in the coming years.
“I think home-based care is going to grow going forward. And in palliative care, we help to make sure we include the patient’s voice in their care,” Dutta said. “We help them be involved and engaged in their own decision-making so they can determine the course of their treatment and their disease.”