Recent research puts it simply: “Population health community-based models of palliative care can result in more compassionate, affordable, and sustainable high-quality care.”1
But what exactly is community palliative care? What value does it offer hospice providers — and patients — and how can hospices create effective community based-frameworks? Let’s dive in.
What is Community-Based Palliative Care?
The community-based palliative care (CPC) model looks to combine inpatient and outpatient services across the entirety of palliative care, from initial care in-home to the eventual transition to hospice facilities and end-of-life. According to an article in the Journal of Pain and Symptom Management, the CPC model has three key components.2
- Consistency across transitions
Services must be continuous across transitions that include physical locations — such as the move to hospice — along with philosophical and disease-related transitions that shift care from chronic illness management to more palliative patient approaches.
CPC models are also prognosis-independent, which means they’re not tied to the disease or its progression but rather the needs of patients and their families.
- Collaborative and coordinated
Finally, these models must include regular, multidomain assessments conducted by care teams to create comprehensive management plans that provide coordinated and ongoing support.
The Value of Community Hospice Care
While the terms “palliative care” and “hospice care” are often used interchangeably, they’re not identical. Where palliative care typically refers to care that reduces pain and discomfort during any stage of a serious illness — from initial onset to advanced progression — hospice care refers to the care received as patients approach their end-of-life, within the last six months.
As noted above, however, the CPC model is designed to be prognosis-independent, which means that community-based care continues even as patients make the transition to hospice. In practice, applying this model allows hospice providers to increase patient comfort by delivering a consistent experience that aligns with existing palliative care practices to minimize disruption.
Consider a palliative care patient living at home that decides to make the transition to hospice. The CPC model focuses on maintaining existing care frameworks as much as possible even as locations change, in turn making the transition and ongoing pain, treatment process and system management more streamlined.
Creating Community Frameworks In-Hospice
So how do hospices create effective CPC frameworks?
Interdisciplinary groups (IDGs) form the foundation. By combining care from physicians, nurse practitioners, social workers, pharmacists, and spiritual support staff, hospices can create a comprehensive approach to pain and symptom management that goes beyond physical discomfort to help patients manage both mental and emotional stress. According to the National Hospice and Palliative Care Organization (NHCPO), IDGs must then work in concert to create a comprehensive analysis of patient symptoms and stressors, coordinate care plans across both in-house groups and outside community services, and take accountability for overall patient care and comfort.3
In practice, building an effective IDG team requires robust staff and schedule management tools. Hospice teams need to know what services are being provided, when, and how, and then document key outcomes. As a result, intuitive scheduling and reporting software is a critical component of community hospice and palliative care. By providing staff relevant data about patient conditions and care, teams are better equipped to deliver a seamless community care experience.
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1 The Journal of Palliative Medicine, “Effects of a Population Health Community-Based Palliative Care Program on Cost and Utilization,” September 1, 2019.
2 The Journal of Pain and Symptom Management, “Community-Based Palliative Care: The Natural Evolution for Palliative Care Delivery in the U.S.,” August 1, 2013.
3 National Hospice and Palliative Care Organization (NHCPO), “Community-Based Palliative Care Demonstration Model,” 2020.