New York City Health and Hospitals Corporation
New York City Health and Hospitals Corporation’s (HHC) Palliative Care Initiative has grown significantly since it launched in 2006. Last fall, HHC announced the number of New Yorkers seeking palliative care services increased by 33 percent for patients at 11 hospitals and 89 percent for those seeking outpatient services. HHC provides consultation services at all of its 11 hospitals and one long-term care facility, as well as inpatient services at Metropolitan Hospital and Coney Island Hospital.
HHC’s $3 million program includes doctors, specialists, nurses, social workers, chaplains, psychologists, ethicists and others who help patients and their families deal with serious debilitating or fatal illness. The program also involves an in-house data collection web application. The application works in harmony with the National Palliative Care Registry, but was developed by in-house palliative care experts in consultation with HHC’s information technology team. It is notable for converting a global patient functionality scale for electronic use, as well as its ability to manage allocation of resources and provide better quality of care to the patient.
A few highlights from New York City Health and Hospitals Corporation’s varied Palliative Care programs:
Coney Island Hospital
In April 2010, Coney Island Hospital expanded its palliative care service – adding a new dedicated 19 bed in-patient unit to its existing consultative scatter-bed model. This newly-created pain and symptom control palliative unit allows the hospital to concentrate on the necessary spiritually- and culturally-appropriate psychosocial and physical services at the patient’s bedside 24-hours a day. Each staff member – volunteers, clerical staff, housekeeping personnel, nurse aides, social workers, case managers – has undergone specialized training in communication techniques, pain management and symptom control for patients experiencing intense pain or symptoms associated with advanced disease.
In addition to clinical services and education, staff provides spiritual support to patients and their families. A special Family Comfort Room allows for spiritual counseling, bereavement support, and privacy during a time when patients and their families most need it.
The Palliative Care Service incorporates inter-institutional and community resources for seamless transition among services and settings when transferring patients to their home, hospice or a long term care setting.
Metropolitan Hospital Center
Metropolitan Hospital Center has a full-service Department of Pain Management and Palliative Medicine, with both in-patient and out-patient care in the pain and palliative care clinic. The department instituted a fellowship in palliative care, accredited by the Accreditation Council for Graduate Medical Education (ACGME) in 2009. Its innovative role also extends to a clinical research component with funded protocols on pharmaceutical pain control.
Elmhurst Hospital
Elmhurst Hospital has received outside funding to hire additional personnel – a physician and a social worker – who will enhance bereavement services and continuity of care and increase access to hospice placement.
Bellevue Hospital
The Palliative Care consultation service at Bellevue has the largest interdisciplinary team, with several therapies - such as psychological, occupational and physical - included in its case conferences delivered by psychologists and occupational and physical therapists. The Bellevue team includes child life specialists to address the needs of children who are dealing with the life-limiting illnesses of their parents. Bellevue is currently creating an outpatient palliative care clinic with a focus on pain control for those in its area who are not in hospice, home care or nursing facilities.