In this episode, we hear from Drs. Robert Friedman and Kate Tindall of Austin Palliative Care in Texas about their journey in establishing a home-based palliative care program. They discuss the challenges of designing their program, and how they used years of strategic research to identify their patient population, understand the unique needs in their city, and ultimately drive referrals. They share insights on balancing growth with delivering high-quality care, and how palliative care can be a model for value-based care – with the potential to improve quality of care and reduce costs.

How Research Informed a Home-Based Palliative Care Program from the Start

In this episode, we hear from Dr. Patricia Fogelman, DNP, about being brought in to lead the palliative care program at Guthrie Clinic, a rural integrated health system located in north central Pennsylvania and upstate New York, serving 12 counties. We learn about the many ways she’s proving the value of palliative care by engaging within and outside of her institution, creatively finding solutions to showcase what high-quality palliative care looks like, while overcoming limited resources. We also learn how the pandemic positioned her to accelerate her team's visibility, which allowed her to assume an institutional leadership role.

Expanding Access to Palliative Care within a Rural Health System

Sue Degnan, a retiring palliative care social worker at Huntington Hospital, reflects on her accomplished 52-year career. She discusses the role of the social worker on the palliative care team, and shares why she thinks her successor is the right person to fill her shoes.

The Role of the Palliative Care Social Worker with Huntington Hospital

In the first episode of the Program Spotlight podcast series, we speak with members of the palliative care team from CHI Health Palliative Care in Omaha, Nebraska. At the time of this recording, CHI provided inpatient consults across 5 hospitals, with a projected 1,300 consults this year — over 3,700 patient encounters. The program is supported within the clinic structure and works closely with the hospital medicine program. With two physicians, one nurse practitioner, 3.5 RNs, and administration support, pastoral care, and social services, the palliative care team is able to provide care across multiple campuses.

Getting Institutional Buy-In with CHI Health Palliative Care

In this episode, we are joined by Katie Perkins, director of palliative care for  Sincera Supportive Care and Symptom Relief — a palliative care program owned and operated by Hospice of Northwest Ohio. In this episode, we hear the story of enormous programmatic growth, in terms of staff and reach. Among the many topics we cover in this conversation, Katie offers advice for bringing palliative care into the community setting.

Meeting the Needs of a Growing Population with Hospice Of Northwest Ohio

The palliative care program spotlight series continues with Rab Razzak, MD, director of outpatient palliative medicine at Johns Hopkins Hospital. In this episode, Dr. Razzak explains his focus on education and staff wellness for his team.

Team Wellness and Education with Johns Hopkins Medicine

In this episode, we are joined by two members of the Flagstaff Medical Center palliative care team in Arizona — Emmalee Kennedy, MD, medical director, and Donna Clark, RN, palliative care nurse and clinical coordinator. They share the story of their growth, and walk us through the strategies employed to enhance team wellness, securing institutional buy-in, maintaining consults, and much more.

Managing Program Growth with Flagstaff Medical Center

In this episode, we are joined by John Mulder, MD, FAAHPM, medical director of Trillium Institute and Holland Home Palliative Care. After beginning clinical services in 2007 with home-based and skilled nursing facility consultations, hospital consult services were added in 2008, and outpatient clinic services in 2011. Trillium Institute went on to launch in 2014, in order to develop a portfolio of educational resources for local universities, public events, professional schools, and health care institutions — and to implement navigation services for patients and families living with serious illness. In this discussion, Dr. Mulder explains how these programs have evolved over the years.

Educating the Community on Palliative Care with Trillium Institute

In this episode of Program Spotlight, we are joined by Sandhya Rao, MD,  director of Palliative Care Service at Boston Medical Center who discusses how she has helped grow the program through team leadership. Originally recruited as a part time hospitalist and palliative care clinician, Dr. Rao has made it her mission to grow the palliative care program.

Taking a Team to the Next Level with Boston Medical Center

This episode of Program Spotlight features a conversation with David Ross Russell, MD, of ProHealth Physicians in Connecticut. Both a family and palliative care physician, Dr. Russell is currently running the palliative care program within ProHealth. In the first part of this conversation, we discuss finding the right patients; payment; and achieving institutional buy-in to meet a growing need. And then, Dr. Russell discusses his program’s successes and challenges in expanding into the community setting.

Payment and Billing with ProHealth Physicians

In this episode of Program Spotlight, we are joined by Christine Swift, MSN, CHPN, CCRN, and manager of the palliative care service at Community Regional Medical Center in Fresno, California, who discusses how data has helped her team reach new heights and plan for the future.

Collecting and Leveraging Data with Community Regional Medical Center

Lori Yosick, LISW-S, CHPCA, director of community palliative care at Trinity Health, is one of the country's leading experts in palliative care. In addition to running the program at Trinity, Lori spends her time helping other palliative care programs extend their inpatient services to the outpatient setting. 

In this episode, Lori shares tips for starting, growing, and sustaining an outpatient palliative program. She also discusses how her own missteps in starting an outpatient program taught her the valuable lesson of planning ahead.

Starting and Sustaining an Outpatient Palliative Care Program

In this episode, we are joined by Ira Byock, MD, and Kevin Murphy, MD, MSW, of the Institute for Human Caring of Providence St. Joseph Health. They discuss bringing uniformity to all palliative care programs at their fifty-hospital health system. Additionally, they discuss making the business case for palliative care; the importance of educating all clinicians in palliative care skills; and creating a health system culture that stays true to its core values.

Palliative Care from the Top Down with Dr. Ira Byock

Our guest in this episode is Kristin Edwards, MD, who oversees the palliative care service line at Bridgeport Hospital. Responsible for clinical supervision, hospital staff education, and metrics and measurement, Dr. Edwards shares she builds lasting relationships with referring clinicians. She also discusses how she  attracts the "right" referrals, presents lessons learned in building an outpatient palliative care business plan, and details how to deliver palliative care to the patients who need it most.

Breaking Down Barriers with Referring Clinicians

In this episode, we speak with Dr. Alexander Gamble, MD, medical director of supportive care at Phelps County Regional Medical Center in Rolla, Missouri. Dr. Gamble discusses how he is growing a palliative care team from the ground up, building relationships with referring clinicians, and the challenges of branching out into the rural setting.

Establishing and Growing a Palliative Care Team

In this episode, we are joined by Abi Katz, DO, medical director of Advanced Illness Management at Fidelity Health Care and Premier Health. She shares how her palliative care programs use data to assess their biggest issues, such as: finding the right consults, staffing properly, and demonstrating value to institutional leaders.

Using Data to Find the Right Patients

In this episode, we are joined by Greg Kimura, MD, director of palliative care for Monarch Healthcare in Orange County, California, who discusses caring for patients through the continuum of care, as well as the importance of patient satisfaction and physician training.

The Big 3: Quality of Care, Provider Satisfaction, Cost Effectiveness

In this episode, Parag Bharadwaj, MD, chief of Palliative Care Medicine at Sentara Health in Norfolk, Virginia, discusses challenges in hiring staff, as well as sharing some of recipes for keeping team members engaged for the long term.

Hiring, Training, and Retaining Palliative Care Staff

How do you staff appropriately when your consults are steadily growing? And how do you scale your business model to continue to reach the right patients? 

In this episode, we speak with Teresa Harvey of Transitions Lifecare in Raleigh, NC, whose program jumped from 300 to 800 consults. Teresa discusses her bundled payment model, how she finds and trains the "right" staff, and her desire to expand her program's reach in the community setting.

Navigating Success and Managing Growing Pains

In the episode, we speak with Julie Lehn, PharmD, clinical pharmacy specialist in palliative care at Banner Health in Phoenix, AZ. She discusses how adding a pharmacist to a palliative care team can save an organization money, increase referrals, and reduce readmissions.

Integrating a Pharmacist into the Palliative Care Team

It is not uncommon for palliative care specialists to feel overworked, especially if the team is understaffed. 

In this episode, we speak with Wendy L. Knowlton, DO, a palliative care specialist with Providence Sacred Heart Medical Center in Spokane, Washington, who has experienced burnout firsthand. Wendy shares how at the time of burnout, she felt extremely overwhelmed and exhausted from the difficulties of her job, and discusses how this experience helped her make changes for the better.

Team Wellness: Avoiding and Overcoming Burnout

In this episode, we are joined by Adriane Mackie, RN, and Jennifer Blechman, MD, of Partners in Care in Oregon, who discuss building and growing their outpatient palliative care program. They share how they have worked with referring physicians to create a culture where upstream palliative care is seen as an extension of their care.

Moving Upstream: How to Create a Culture of Palliative Care

In this episode, Bob Bergamini, MD, of Mercy Palliative Care Services in St. Louis, shares how his palliative care program has helped to reduce readmission rates for his organization.

Reducing Hospital Readmissions through Palliative Care

How to Better Care for Dementia Patients

In this episode, Mary Alfano-Torres, MD, medical director of Chapters Health Palliative Care in Florida, discusses how she prepared her staff to handle the program's tremendous growth. We are reminded that success sometimes comes with growing pains, and that it is important to balance business and patient care.

Overcoming the Challenges of Successful Growth

In this episode, Stephanie Houck, MD, of UT Southwestern Medical Center in Dallas, Texas, discusses how she proved her program's value through data and metrics, when faced with a change in funding. Dr. Houck also discusses how she promotes palliative care within her organization, as well as it’s expansion into additional hospital settings, including the emergency department, oncology, intensive care, and ambulatory care units.

Showing Your Program's Value and Return on Investment

In this episode, we are joined by Jeanne Elnadry, MD, director of supportive/palliative care at Yuma Regional Medical Center, who develops palliative care programs, systems, and initiatives throughout her organization —
educating clinicians on palliative care principles and practices. 

Dr. Elnadry shares what palliative care programs can do if and when budget is cut significantly, and how to evolve if an organization does not provide the support needed to serve patients.

Facing the Challenge of Budget Barriers

In this episode, we are joined by Shauna Anderson, RN, of Chautauqua Hospice & Palliative Care in Lakewood, NY. We discuss her team's success in hiring and how an investment in marketing has shown promising results in program growth.

Marketing Your Palliative Care Team

Music and Memory: Improving Alzheimer's and Dementia Care

Kathy Selvaggi, MD, director of palliative care at Butler Health System, steps into the program spotlight to discuss how she helped build her organization's palliative care program. 

In this episode, Dr. Selvaggi shares that being direct and transparent with leadership, staff, and community partners is the key ingredient to her program's continued success. She also talks about the importance of marketing her palliative care program within the community.

Building a Program from the Ground Up

Dr. Diana Martins-Welch, palliative care physician at Northwell Health Long Island, discusses how she built the outpatient palliative care practice as part of her organization's cancer institute. She shares observations about growing from a sole provider to a small team, achieving earlier referrals from her oncology colleagues, and expanding the team’s visibility to support more patients.

Teachable Moments: Proving the Value of Palliative Care

Dr. Chin-Lin Ching, medical director of palliative care at Highland Hospital, joins her mentor, Dr. Diane E. Meier, director of the Center to Advance Palliative Care for an interview.

In this episode, Dr. Ching shares how she turned around her program, which was considered successful on paper (based on high and rising volume), but unsustainable due to strains on staffing — causing her team to feel overwhelmed and burnt out. Instead of walking away, Dr. Ching took steps to overcome her feelings of despair, which included research, planning, and implementing change.

For more information, visit: https://www.capc.org/blog/how-program-leader-climbed-despair-success

A Program Leader's Journey from Despair to Success

Dr. Jessica Israel, senior vice president of geriatrics and palliative care at RWJ Barnabus Health in New Jersey, shares how she built a palliative care service line across the largest academic health care system in the state. She discusses how her communication skills expertise (from palliative care training) set the stage to achieve systemwide collaboration, and how she purposefully sought to unify, improve, and streamline the teams and processes, while allowing each site to retain its own personality and structure.

Building a Systemwide Palliative Care Collaborative

CAPC’s podcast, Program Spotlight, highlights successes and challenges faced by palliative care programs — across organizations of all sizes and settings. Each episode features an in-depth interview with a palliative care program leader or specialist covering common themes such as managing growth, improving the referral process, team wellness, organizational buy-in, relationship building, and much more.

This podcast is available to listen on SoundCloud, Apple Podcasts, Spotify, GooglePlay, iHeartRadio, and Stitcher.

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