January 23, 2006
care programs open at Emory hospitals, Grady
faulk & alicia sands lurry
Emory and Crawford Long hospitals have launched a new palliative care program designed to enhance quality of life for patients suffering from serious, chronic or terminal conditions, and Grady Hospital has received a grant to support a similar operation.
According to Mark Williams, professor of medicine and director of the hospital medicine unit, palliative care focuses on the many ways serious illness affects patients and their families. The goal of the program at Emory and Crawford Long is to help patients by relieving the physical—and non-physical—suffering that accompanies serious illnesses. Palliative care programs also address mental health and spiritual needs.
“Providing palliative care is essentially healing at a higher level,” Williams said. “By integrating multidisciplinary care to augment clinical services, we can better help our patients and their families at a vulnerable point in their lives.”
Palliative care teams work closely with primary physicians to control pain and relieve symptoms of illnesses (nausea, fatigue, depression); to help provide counseling in making difficult medical decisions; to give emotional and spiritual support; and to coordinate home care referrals and assist with identifying future care needs.
“This program is staffed by internal medicine physicians (hospitalists) and co-directed by two hospitalists who are specifically board-certified in palliative care, making Emory the first health system in Atlanta with a physician-led palliative care program,” Williams said. “Hospital-based palliative care is a rapidly growing trend in health care, and we are perfectly situated to provide services to a wide variety of patient groups.”
Doctors Melissa Mahoney and Stephanie Grossman, along with registered nurse Donna Arena, make up Emory’s core palliative care consult team.
Not to be confused with hospice care, palliative care is appropriate for patients in any stage of illness, whereas hospice care is primarily used for those approaching the end stage of life. A typical palliative care team consists of physicians, nurses, social workers, chaplains and pharmacists, assisting patients suffering from a wide array of illnesses, including stroke, heart disease, cancer and HIV.
Meanwhile, the Grady Cancer Center for Excellence received a $200,000 grant from the Lance Armstrong Foundation to establish a palliative care clinic for cancer patients at Grady, the hospital’s first such clinic. Tammie Quest, assistant professor of emergency medicine, is the clinic’s medical director.
Quest said the clinic will deliver well-managed, high-quality care to at least 200 cancer patients requiring long-term management of complex and multiple problems. Recently opened, the center initially will serve Grady cancer patients one afternoon each week but eventually will receive referrals from other clinics in the hospital. All patients will receive comprehensive symptom, psycho-social and spiritual assessments.
“Our focus is to have an interdisciplinary, culturally sensitive clinic that actually takes into account issues of spirituality and faith-based decision making,” Quest explained. “Our hope is that this program will be an initiation of one model of palliative care at Grady with the idea that it will extend into a hospital-based service that will include more than just cancer patients.”
Grady’s clinic is modeled after a similar program at Parkland Memorial Hospital in Dallas.
“Because patients in indigent care populations have lots of complex needs, the idea is to have intense case management focusing on those issues,” Quest said. “Our primary outcomes are going to be decreased hospitalization, decreased emergency department visits, decreased pharmacy costs and increased quality of life for those patients.”