Published in the July/August edition of HomeHealthcare now was an article by Therese Rochon, MS, MS, FNP-C, ACHPN and Esther Emard, MSN, RN, MSLIR entitled End-of-Life Care: Redesigning Access through Leveraging the Institute of Medicine Future of Nursing Recommendations. Ms. Emard is a member of the Graduate Faculty for the GW School of Nursing and also an Adjunct Instructor for our GW School of Health Sciences and the former Board member for the Care New England Health Care System (CNE) in Rhode Island which was the cite of this improvement effort/program. Ms Rochon is the CNE Director of the Advance Illness Management Program and certified in Palliative Care.
This article described a quality improvement program effort which was designed to allow patients to remain in their preferred setting of care, their home, until the end of their life. This program’s goals are consistent with the 2010 Institute of Medicine published vision for how to transform the health care system to achieve a more seamless patient-centered high quality system of care. In the five years of this programs existence, it has achieved a yearly impact on the community based palliative care and hospice services. The number of documented advance directives increased by seventy five percent, referrals to palliative care and hospice increased by three hundred percent, the length of time on hospice doubled. The addition of NP home visits became an accepted referral source and improvements in both the quality and satisfaction scores for the home health agency were realized. Also discussed was how this program’s successful outcome was enabled as a result of the alignment and engagement between a member of the Health System’s Board of Directors, VNA leadership, staff and Quality Committee which included community representation.