A Public-Private Collaborative to Enhance Palliative Care Resources in Rural Communities

IF 3.5 2区 医学 Q2 CLINICAL NEUROLOGY Journal of pain and symptom management Pub Date : 2025-04-10 DOI:10.1016/j.jpainsymman.2025.02.068
Gregg VandeKieft MD MA, Adrienne Goldberg PhD LICSW, Amber Moody RN CHPN
{"title":"A Public-Private Collaborative to Enhance Palliative Care Resources in Rural Communities","authors":"Gregg VandeKieft MD MA,&nbsp;Adrienne Goldberg PhD LICSW,&nbsp;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.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
加强农村社区姑息治疗资源的公私合作
Outcomes1。参与者将能够阐明为什么在农村社区获得有限的姑息治疗既是一个质量问题,也是一个DEI问题。与会者将能够描述农村社区的姑息治疗倡导者与跨学科范围的远程专业姑息治疗提供者之间的合作,以及项目设计和开发专家之间的合作,如何能够提高农村社区患者和临床医生获得高质量姑息治疗的机会。希望提供姑息治疗的农村社区面临许多障碍,导致农村居民在获得姑息治疗方面存在不公平现象。本次会议将重点介绍由我们州卫生部与20多个其他伙伴组织发起的创新公私伙伴关系,以开发资源,为20个参与的农村社区提供专业的跨学科姑息治疗支持。想要提供姑息治疗(PC)的抽象社区面临着一些障碍,包括缺乏当地专业知识、临床培训、资源、有限的护理和家庭健康可用性、人员流动以及由于数量少而对专门的PC人员提供资金的行政阻力。农村居民在获得服务、资源和机会方面面临地理障碍。(1)在这一人口中,不同社会经济群体在健康和死亡率方面存在很大差异。(2)该倡议农村社区的患者无法获得姑息治疗,造成了在获得高质量、全方位医疗保健方面的不平等。该倡议的主要目标是为参与的农村社区提供个性化支持。最初,社区参与战略将每个社区的不同组织聚集在一起。制定了资产/差距分析,以制定个人电脑行动计划,并每年重新审查。社区的目标包括开展临床筛查、提供咨询服务、开展公共教育、改善协调以及获得非医疗支助。临床和文化变革战略包括技能培训、变革管理、技术援助、促进、证据收集、临床标准采用、工作流程设计支持、在线资源门户和教育系列。目前总共有20个社区在6年多的时间里加入了三个队列。“学习与行动网络”强调同伴间的指导。增强集中的专业知识,团队对自己组织和社区的深入了解为其他参与者带来了深度和意义。在发展地方姑息治疗方面,我们通过使治疗计划与患者和家属的护理目标保持一致,重点关注减少向偏远城市中心的转移。在医院系统面临竞争性财政需求之际,该倡议协助社区制定可持续服务的筹资模式。结论强有力的集中领导和视野聚焦于每个参与社区的独特需求和优势,可以促进创新合作,以提高农村社区获得专业、个性化姑息治疗资源的机会。Lam O, Broderick B和Toor S.皮尤研究中心。美国人离最近的医院的距离因社区类型而异。2018年12月12日可从:https://www.pewresearch.org/short-reads/2018/12/12/how-far-americans-live-from-the-closest-hospital-differs-by-community-type/。于2024年8月8日发布。2. 美国医院协会。农村报告:农村社区面临的挑战和确保当地获得高质量、负担得起的医疗服务的路线图。2019年2月。可从:https://www.aha.org/system/files/2019-02/rural-report-2019.pdf。于2024年8月8日发布。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
8.90
自引率
6.40%
发文量
821
审稿时长
26 days
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.
期刊最新文献
PC-FACS November 3, 2025. Hospice Clinicians' Approaches to Terminal Restlessness: A Qualitative Analysis. The association of goals of care note content with patient care plan decisions. Evaluation of the Palliative Prognostic Score (PaP) in a cancer center-based palliative care clinic. Mindfulness-Oriented Recovery Enhancement for cancer pain relief: Pilot randomized controlled trial.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1