A California program has helped hospitals establish palliative care services, according to a recent study evaluating the program 1 year after its completion.
Given that more than half of people in the United States die in a hospital, end-of-life care is an important part of hospital services. Established palliative care services might help hospitals better provide for these patients and their families. The California Hospital Initiative in Palliative Services (CHIPS) program was designed to assist hospitals in organizing such programs (Arch. Intern. Med. 2006;166:227–30).
Dr. Steven Z. Pantilat of the University of California at San Francisco and associates recruited all types of hospitals across California for the program. Interested hospitals had to demonstrate their readiness, obtain administration approval, and pay a $2,500 fee. “The typical hospital participating in CHIPS was a large, not-for-profit, private hospital in an urban setting that had a hospitalist program,” noted the investigators.
The 38 participating hospitals sent three-person multidisciplinary teams to a skills conference where they were paired with a CHIPS mentor. For 10 months, mentors consulted regularly with the teams. Between 8 and 11 months after the first conference, a reunion conference was held focusing on participants' needs, challenges, and successes. Two cohorts of hospital teams have completed the program.
A follow-up cross-sectional telephone survey was conducted 29 months after the initial conference for cohort 1 (18 months for cohort 2). By the time of the survey, of the 32 hospitals without a palliative care program, 19 had established new palliative care consultation services, a success rate of 60%. The six hospitals with existing services continued to offer them, giving an overall success rate of 66%. Urban hospitals and those with a hospitalist program were significantly more likely to establish new programs.