Utilization of a Palliative Care Team to Improve Rural Chronic Care: A Feasibility Study

Abstract

Purpose: To determine if it is feasible for San Luis Valley Health to implement a new palliative care service line to improve rural chronic care. Background: Colorado hospitals are facing increasing financial and operational challenges. Rural populations are known to be older and sicker than their urban counterparts, and there are fewer options for safe discharge at the end of life. Not only is the San Luis Valley rural, but it is also large and geographically isolated from tertiary healthcare. Methods: Primary Care Providers were surveyed regarding their knowledge of palliative care and their patients' understanding and perception of it. They were also asked if they had an interest in palliative care. Hospital data were obtained and compared to known national data to ascertain the potential financial impact of a palliative care team. A SWOT analysis was conducted to identify readiness for implementing palliative care. Results: Twelve responses were returned from the 15 primary care providers surveyed (80%). The majority (75%) felt confident in their knowledge of palliative care and that their patients would benefit from palliative care. They also felt that palliative should be available as an inpatient and an outpatient service. Six (50%) reported that being unable to spend time on palliative care resulted in job dissatisfaction. One (8%) expressed interest in becoming a palliative care provider, and three (25%) wanted to know more. The Summary of Estimated Financial Impact: Direct Cost Savings data indicated a potential savings of more than $600,000 to the facility annually. The SWOT analysis indicated that SLVH already has many resources to facilitate the implementation of a palliative care program.