When time is limited, a new model of hospice care

Twilla Harrington, RN, BSN CHPN WCC
Clinical educator, Providence Home Services

March 19, 2014

More patients than ever rely on hospice for end-of-life care, yet these patients often are admitted late in their disease process. In fact, half die within two weeks after being discharged at home or to a care facility.

To provide the best outcomes for these patients, Providence Home Services has developed an “acute care track clinical pathway,” a process that involves caregivers across disciplines who plan and coordinate care according to immediate needs.

If it's determined that the patient is likely to die within 14 days after being admitted to hospice, the ACT process is triggered. The care team – which may include a nurse, social worker, chaplain, hospice aide and volunteer – huddles each morning to determine what the patient needs for that day. Does he or she require extensive wound care? Is the family in distress? Should a nurse visit or is a hospice aide needed? Can a social worker help the family find resources and support?

The goal of this rapid-response approach is to ensure the best outcomes for patients and families in a brief time period fraught with grief and often confusion. Although this approach is associated with positive results, care pathways do not replace the judgment of the patient's clinicians.

This acute care track clinical pathway took effect last month in the Portland Service Area. We'll share outcomes in a future issue of Pulse.