Des Moines, Iowa-based UnityPoint Health, which serves communities across
Palliative care has become more popular in the last decade among hospitals and healthcare facilities across the nation. However, the expanding service faces challenges related to provider shortages in the face of increased demand. According to Monique Reese, DNP, ARNP, FRP-C, ACHPN, vice president of clinical services and chief clinical officer of UnityPoint at Home, there are too few certified palliative care specialists being trained for the number of patients who could benefit from the specialty. Indeed, the number of elderly people in the
UnityPoint has made a commitment to its palliative care program, which began back in 2005 when UnityPoint identified a need to address frequent admissions. Since then, the program has expanded across UnityPoint's seven regions in
UnityPoint palliative care core teams consist of nurse practitioners, physicians, registered nurses, licensed independent social workers and chaplains. "We bring in other disciplines as needed on a single-patient basis," says Dr. Reese. "We approach that patient and family from a holistic standpoint, including psychosocial, emotional and spiritual perspectives."
UnityPoint often uses patient stories to demonstrate how its palliative care program works holistically with patients. One patient, Vivienne, had Parkinson's disease and dementia. Both Vivienne and her husband, Charles, had expressed a desire to keep Vivienne in a home-care setting for as long as possible, but as Vivienne's conditions advanced, Charles had a hard time keeping up.
After a consultation with UnityPoint's palliative care program, in this case mostly with a social worker, Charles was better able to understand Vivienne's symptoms and be proactive in managing her health. The palliative care program helped Charles to coordinate with a community memory clinic and negotiate a gap in their insurance coverage to make sure Vivienne didn't go without her medications. Improving Charles' capacity for problem-solving where it applied to Vivienne has empowered the couple to meet their initial goal of home-care and has kept Vivienne out of the hospital for over a year since the initial consultation.
Not only are UnityPoint's palliative care teams customizable according to the needs of a specific patient, but they also follow patients across UnityPoints healthcare continuum. The nurse you see at the hospital may be the same nurse you see in a skilled facility setting, explains Dr. Reese.
UnityPoint's program is also data-driven. It has instituted programmatic data collection in operational, financial, clinical and patient experience domains to identify and institute evidence-based best palliative care practices. Use of data and evidence based practice has helped UnityPoint decrease pain by 49 percent and dyspnea by 45 percent in acute-care settings and pain by 27 percent and dyspnia by 31 percent in community settings in the lifetime of its program.
Dr. Reese says that UnityPoint's integrative approach to palliative care has ensured program success. "We provide services wherever the patient and family are located: in the home setting, or in an acute clinic, skilled or assisted living facilities," she says. "Hospitalization is not a requirement to be met by the palliative care team."
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