"As a nurse myself, you make me proud. To me, you are heroes!!"
Below are some questions that you should ask your candidate hospice provider(s) based on the National Hospice Foundation guide to choosing a Hospice [Utah Hospice Specialists answers in bold]:
If it is a hospice, is it Medicare certified? Yes
Is care provided by an interdisciplinary team with appropriate training? Yes
Are staff certified in hospice and palliative medicine? Yes, Dr. McPherson, MD is Board Certified in Paliative & Hospice Medicine.
Are the following services provided: medical, nursing, social work, volunteer, bereavement, and spiritual? Yes, all.
What is the average caseload of the registered nurse? 10 patients. Social worker? 22 patients. Home health aide? 7 patients. Spiritual counselor? 40 patients Volunteer? Varies
How many hours per week do the medical director and physician staff work? 25 hrs.Is staff available 24 hours a day, 7 days a week, including visits by spiritual and social work services on the nights and weekend if there is a patient or family need? Absolutely
Is there a dedicated inpatient hospice or palliative care unit? Utah only has one of these. We have inquired to open another one, but current bed availability moratoriums by the state restrict the development of another inpatient hospice. Utah Hospice Specialists has relationships with the best facilities in the state to offer inpatient care.How many beds? Unlimited with partners How long can the patient stay in that unit? Varies by patient need.
Is there a waiting list for the unit? NoDoes each team member use a standardized assessment tool? Yes
How is this information conveyed back to the primary care physician? Phone, electronically, written word.What policy and procedures are in place to ensure that patients receive their desired level of comfort? Pain is treated until (patient identified) acceptable level is met via multiple relief modalities.
If patients wants to remain alert while dying, how does the program work with patients to achieve that goal? Aggressive care planning to insure adequate pt support is available, medication therapy/emotional/caregiver support needs identified.
What are the policies and procedures regarding palliative sedation? Case by case-never used to this time.How often is it used? 0 Is there a formulary? n/a
Which medications are covered? Medications required for the symptom management of the terminal disease.If the patient has a special need for a particular category of opioid, how easy is to get that drug approved? We have experience in managing special needs including opioid and it is not a problem.
How are decisions regarding the use of x-rays, laboratory treatments, and expensive diagnostic tests made? Discussion with Inter Disciplinary Care Group and how the information will affect the outcome/care.What palliative treatments can patients receive while in hospice? Most treatment deemed as comfort measure vs. curative or to prolong life.
What special types of programs are available (e.g., life review, pet therapy)? Music/massage/spiritual/visual imagery/memory keepers
Where do bereavement groups meet? Senior Centers, Hospital Classroom, Park, Various placesAre meetings held during nonworking hours? Yes
Does the program use complementary therapies (e.g., music therapy, Reiki, massage, or therapeutic touch)? Yes
Does the program provide care to dying patients in all settings?At home? Yes Nursing home? Yes Hospital? Yes Assisted living? Yes
Are intravenous services provided in various settings (e.g., in the home, nursing home)? Yes, allWhat bereavement services are provided? Visit, letters, group meetings, memorials
What is the frequency of contact? Approximately 12 contacts during year following the death.Continuity and Coordination of Care What steps does the program take to coordinate care across settings of care? Team meetings, joint care planning, 1:1 communications evidenced by signatures.
Is there one case manager assigned to the patient? YesHow does the service coordinate the care plan with other health care professionals, especially the primary care physician?
Weekly care plan fax, notes in chart, letters.<Patient- and Family-Centered Care How is the care plan developed and evaluated to ensure adequate input from the patient and family? Developed in care setting with appropriate caregivers attending.
What education is in place for the patient and family? Patient care book given to each family, multiple various hand outs/booklets.
Is the staff trained in cultural competency? Yes-continuing education in-services.<Are interpreter services available 24 hours a day, 7 days a week? As available per Inter Disciplinary Care Group and resources available/set up per SW.
Are there special outreach programs available for minority communities? NoAccess to Care What range of services and access to specialist care is available to patient, family, or both? Anything deemed reasonable and appropriate under the definition of hospice care.
What organizational relationships are in place to ensure the patient has access to proper care across the disease trajectory and during transitions in settings of care? Contracts with ALF/SNF/hospitals/private duty companies etc�Commitment to Quality How does the program monitor and improve its quality of care? Audit/outcome measures/QA meetings/ongoing continuing education.<
How many patient and family complaints were received in the last year? ThreeHow were they resolved? Resolved based on need depicted by the complaint.
Does the program monitor for medical errors or sentinel events? No. Death is considered a sentinel event in a skilled setting but is the intended outcome in hospice.How does the program respond? n/a
How many patients revoke hospice services? <10% of all admissions.For what reasons? Primarily to proceed with aggressive curative care.
How many families contribute donations to the program after the death of the patient? We do not have a foundation in place to receive donation. We are a �for profit � company.Does the program participate in national quality initiatives and benchmarking? No
Adapted in part from the National Hospice Foundation guide on choosing an hospice program. HIGH-QUALITY PALLIATIVE CARE AT THE CLOSE OF LIFE �2009 American Medical Association. All rights reserved. < (Reprinted) JAMA, February 11, 2009�Vol 301, No. 6