Family Medicine News Archive Featured in the Media JeffNEWS

A new service, created to aid chronically or terminally ill patients, has been introduced at Thomas Jefferson University Hospital.

Known as the Palliative Care Service, “this innovative program represents a truly interdisciplinary/interdepartmental effort involving physicians and nurses,” says

Christine Arenson, M.D., director of the division of Geriatric Medicine in the department of Family Medicine at Thomas Jefferson University and Thomas Jefferson University Hospital. “The goal is to focus on a patient’s symptoms and quality of life rather than a cure.”

When referred by a patient’s physician, the Palliative Care Service team meets with the patient to create a plan to focus on their quality or end of life, explains Dr. Arenson, who is also clinical assistant professor of Family Medicine at Jefferson Medical College of Thomas Jefferson University.

Patients who are referred to the service benefit from a list of key performance measures. These include: psychosocial and pain assessments, pain relief or reduction, patient/family meeting and plans for discharge.

As goals of treatment change with deterioration of health status, Palliative Care team members are skilled in assisting patients, families and healthcare providers during the decision process to shift the focus of care from cure to comfortable, dignified dying.

“Studies show that patients really want to know an accurate prognosis and that doctors are often uncomfortable providing such information,” said David Axelrod, M.D., Jefferson Internal Medicine specialist and Palliative Care Service co-director. “As part of the service, we also encourage patients to identify their goals of care. For example, we might focus on pain management and discuss options to keep the patient comfortable. This focus replaces the more traditional method of pursuing invasive and aggressive treatments that lead many patients to spend their final days in an intensive care unit instead of being in the comfort of their homes surrounded by loved ones.”

According to the University Health System Consortium (UHC) Palliative Care 2004 Benchmarking Project Field Book, which interpreted the results of information collected from 35 member hospitals, the Palliative Care Service is both beneficial and cost-effective. Patients receiving eight or more of the key performance measures had an average length of stay at least 3.5 days shorter and an average cost per case at least $8,000 less than patients receiving four to seven measures or fewer than four.