{"title":"A Public-Private Collaborative to Enhance Palliative Care Resources in Rural Communities","authors":"Gregg VandeKieft MD MA, Adrienne Goldberg PhD LICSW, Amber Moody RN CHPN","doi":"10.1016/j.jpainsymman.2025.02.068","DOIUrl":null,"url":null,"abstract":"<div><h3>Outcomes</h3><div>1. Participants will be able to articulate why the limited access to palliative care in rural communities is both a quality and DEI issue.</div><div>2. Participants will be able to describe how collaboration between palliative care champions in rural communities and remote specialized palliative care providers across the range of disciplines, together with experts in program design and development, can enhance access to high quality palliative care for patients and clinicians in rural communities.</div></div><div><h3>Key Message</h3><div>Rural communities wanting to offer palliative care face numerous barriers, creating inequities in access to palliative care for rural residents. This session will highlight an innovative public-private partnership initiated by our state Department of Health, with over 20 additional partner organizations, to develop resources providing access to specialized interdisciplinary palliative care support to 20 participating rural communities.</div></div><div><h3>Abstract</h3><div>Rural communities wanting to offer palliative care (PC) face barriers including a lack of local expertise, clinical training, resources, limited care giving and home health availability, staff turnover, and administrative resistance to funding dedicated PC staff given low volume. Rural residents face geographic barriers accessing services, resources, and opportunities. (1) Within this population, there are wide disparities in health and mortality among socioeconomic groups. (2) Patients in this initiative's rural communities did not have access to palliative care, creating inequities in access to high quality, full spectrum health care.</div></div><div><h3>Objectives</h3><div>This initiative's primary objective is providing individualized support to participating rural communities. Initially, a community engagement strategy brought together diverse organizations in each community. An asset/gap analysis to develop a PC action plan was developed and is annually revisited. Communities targeted objectives such as initiation of clinical screening, launching consultative services, public education, improved coordination, and accessing non-medical supports. Clinical and culture change strategies include skills training, change management, technical assistance, facilitation, gathering of evidence, clinical standard adoption, support for workflow design, an on-line resource portal, and education series. Three cohorts were onboarded over 6 years for a current total of 20 communities. A Learning and Action Network emphasizes peer-to-peer mentoring. Augmenting centralized expertise, teams’ deep knowledge of their own organization(s) and community brings depth and meaning for other participants. In developing local palliative care, we focused on decreasing transfers to distant urban centers by aligning treatment plans with patients’ and families’ goals of care. In a time of competing financial demands on hospital systems, the initiative assists communities in developing funding models for sustainable services.</div></div><div><h3>Conclusion</h3><div>Strong centralized leadership and vision focused on the unique needs and strengths of each participating community allows for innovative collaborations to enhance access to specialized, individualized palliative care resources in rural communities.</div></div><div><h3>References</h3><div>1. Lam O, Broderick B, and Toor S. Pew Research Center. How far Americans live from the closest hospital differs by community type. Dec 12, 2018. Available from: <span><span>https://www.pewresearch.org/short-reads/2018/12/12/how-far-americans-live-from-the-closest-hospital-differs-by-community-type/</span><svg><path></path></svg></span>. Accessed August 8, 2024. 2. American Hospital Association. Rural report: Challenges facing rural communities and the roadmap to ensure local access to high-quality, affordable care. February 2019. Available from: <span><span>https://www.aha.org/system/files/2019-02/rural-report-2019.pdf</span><svg><path></path></svg></span>. Accessed August 8, 2024.</div></div>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"69 5","pages":"Pages e452-e453"},"PeriodicalIF":3.5000,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0885392425001289","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Outcomes
1. Participants will be able to articulate why the limited access to palliative care in rural communities is both a quality and DEI issue.
2. Participants will be able to describe how collaboration between palliative care champions in rural communities and remote specialized palliative care providers across the range of disciplines, together with experts in program design and development, can enhance access to high quality palliative care for patients and clinicians in rural communities.
Key Message
Rural communities wanting to offer palliative care face numerous barriers, creating inequities in access to palliative care for rural residents. This session will highlight an innovative public-private partnership initiated by our state Department of Health, with over 20 additional partner organizations, to develop resources providing access to specialized interdisciplinary palliative care support to 20 participating rural communities.
Abstract
Rural communities wanting to offer palliative care (PC) face barriers including a lack of local expertise, clinical training, resources, limited care giving and home health availability, staff turnover, and administrative resistance to funding dedicated PC staff given low volume. Rural residents face geographic barriers accessing services, resources, and opportunities. (1) Within this population, there are wide disparities in health and mortality among socioeconomic groups. (2) Patients in this initiative's rural communities did not have access to palliative care, creating inequities in access to high quality, full spectrum health care.
Objectives
This initiative's primary objective is providing individualized support to participating rural communities. Initially, a community engagement strategy brought together diverse organizations in each community. An asset/gap analysis to develop a PC action plan was developed and is annually revisited. Communities targeted objectives such as initiation of clinical screening, launching consultative services, public education, improved coordination, and accessing non-medical supports. Clinical and culture change strategies include skills training, change management, technical assistance, facilitation, gathering of evidence, clinical standard adoption, support for workflow design, an on-line resource portal, and education series. Three cohorts were onboarded over 6 years for a current total of 20 communities. A Learning and Action Network emphasizes peer-to-peer mentoring. Augmenting centralized expertise, teams’ deep knowledge of their own organization(s) and community brings depth and meaning for other participants. In developing local palliative care, we focused on decreasing transfers to distant urban centers by aligning treatment plans with patients’ and families’ goals of care. In a time of competing financial demands on hospital systems, the initiative assists communities in developing funding models for sustainable services.
Conclusion
Strong centralized leadership and vision focused on the unique needs and strengths of each participating community allows for innovative collaborations to enhance access to specialized, individualized palliative care resources in rural communities.
References
1. Lam O, Broderick B, and Toor S. Pew Research Center. How far Americans live from the closest hospital differs by community type. Dec 12, 2018. Available from: https://www.pewresearch.org/short-reads/2018/12/12/how-far-americans-live-from-the-closest-hospital-differs-by-community-type/. Accessed August 8, 2024. 2. American Hospital Association. Rural report: Challenges facing rural communities and the roadmap to ensure local access to high-quality, affordable care. February 2019. Available from: https://www.aha.org/system/files/2019-02/rural-report-2019.pdf. Accessed August 8, 2024.
期刊介绍:
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.