Baylor Receives State’s First Joint Commission Advanced Certification for Palliative Care

Robert L. Fine, Baylor Health Care System

Baylor University Medical Center (BUMC) at Dallas is the first hospital in Texas—and one of the first 10 in the nation—to receive advanced certification for palliative pare from The Joint Commission.

The certification process included an on-site visit and review of quality metrics and evidence of effective, timely palliative care using a multidisciplinary approach. It recognizes hospital inpatient programs that demonstrate exceptional patient and family-centered care.

Baylor University Medical Center expanded its palliative care team in 2011. The Joint Commission’s certification requires that palliative care patients interact with the specially trained members of four core disciplines: physicians, nursing, social work, and pastoral care. Baylor was able to increase the number of inpatient consults to more than 700 patients in the fiscal year ending in June, up from 436 from the previous year. Palliative care physicians also see patients in outpatient settings.

The certification “confirms that our program provides quality care for patients and families facing serious illness,” said Robert L. Fine, MD, FACP, FAAHPM, clinical director, Office of Clinical Ethics and Palliative Care for the Baylor Health Care System. “That we are one of the first 10 hospitals in the country and the first in Texas to achieve such recognition is a continuation of Baylor’s tradition of leadership in all branches of medicine.”

The goal of palliative care is to relieve a patient’s disease symptoms, or to minimize a treatment’s side effects. Non-hospice palliative care is not dependent on a patient’s prognosis and may be done in conjunction with traditional curative medical care. People in hospice, who no longer receive treatment to cure their illness, always receive palliative care during their final months of life.

Cuts Average Cost of Care, Length of Hospital Stay

Palliative care is an interdisciplinary approach designed to minimize pain and enhance quality of life for patients and their families. Caregivers provide spiritual and psychological—as well as medical—guidance, sometimes called “comfort care.” Palliative clinicians often help families and patients make difficult decisions about whether to use highly aggressive therapies and sort through treatment options. Those decisions are becoming more complex as medical technology continues to increase the number of choices.

Research has shown that palliative-care patients report improvement in pain or nausea, better communication with their doctors and families, richer emotional support, and care that is more in line with their wishes.

The healthcare system also benefits. Palliative care reduces average cost of care and length-of-hospital-stay by about a third. According to one study, a 300-bed community hospital with a palliative program saves about $1.3 million a year in pharmacy, lab, and intensive care costs. An average academic medical center can save as much as $2.5 million annually.

According to a Baylor study, palliative patients averaged more than $3,000 less in hospital costs than patients with similar conditions who did not have such care. The team has treated more than 3,000 patients since it began its program in 2004, and is a leader in hospice referrals. Nearly one-half of Baylor patients were in hospice in their last six months of life, according to the Dartmouth Atlas of Health Care database.

The Baylor University Medical Center team received one of eight national awards from the American Hospital Association for excellence in palliative care in 2006-07.

Baylor Plano also has an expanding palliative program was well. The hospital appointed a full-time palliative-care nurse in 2010 and added a full-time physician this past January.

Statewide, Texas has been slow to develop palliative-care programs. The Center for Advance Palliative Care and the National Palliative Care Research Center graded each state’s access to palliative care. Texas received a “C.” According to the 2011 study, 42 percent of hospitals with 50 or more beds had a program, compared to 18 percent of hospitals with fewer than 50 beds.

Steve Jacob is editor of D Healthcare Daily and author of the new book Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at steve.jacob@dmagazine.com.

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