Palliative Care: Creating a New Model to Address Suffering for Neurological Illnesses
Wednesday, June 21, 2023
Neurologic illnesses, including Alzheimer’s, brain cancer, amyotrophic lateral sclerosis (ALS) and stroke, are among the most dreaded illnesses in medicine and leading causes of disability and death worldwide. Despite the huge burden of suffering these patients and families face, palliative care is not routinely offered and is used far less than in other illnesses.
In a review commissioned by the journal Lancet Neurology, an international team of experts argue that current models of care do not adequately address the needs of people living with neurologic illness. They propose a new evidence-based framework for early and ongoing palliative care approaches employed by multiple members of the health care team to improve quality of life for individuals with neurological disorders and their families.
“Suffering is the fundamental concern of palliative care. To improve care we must address the total pain of neurologic illness -- not just physical pain, but also psychological, social, and spiritual distress,” said University of Rochester Medical Center neurologist Benzi Kluger, MD, lead author of the article produced by members of the International Neuropalliative Care Society. “This model of care seeks to screen for and prevent suffering by integrating an early approach to palliative care, with neurologists, and other clinicians who care for people with neurological illnesses incorporating a palliative care approach from day one.”
Nearly all neurological diseases cause a wide range of symptoms, including pain, fatigue, and memory loss. Depression, anxiety, social isolation, and loss of independence are also common. Family members typically are the primary at-home caregivers and over time can struggle with the emotional impact of seeing a loved one suffer as well as with the social, financial and physical impact of providing care.
Read More: Palliative Care: Creating a New Model to Address Suffering for Neurological Illnesses
Inpatient Length of Stay Reduction - Gold Award for Team Excellence
Thursday, February 2, 2023
The URMC inpatient Neurology and Imaging Science departments were recently honored with the Gold Award for Team Excellence by the Greater Rochester Quality Council for a project which saved over 150 admissions from the ED and reduced inpatient length of stay. The GRQC, an affiliate of the Greater Rochester Chamber of Commerce, recognizes teams from a wide range of industries that are committed to quality and performance excellence.
This collaboration implemented efforts to reduce a patient’s hospital stay when awaiting an MRI prior to discharge and to prevent unnecessary admissions from the ED beginning in February of 2021 Prior to the launch, data showed that patients who were medically ready for discharge waited an average of two to three additional days in the hospital for an MRI, and many patients were admitted for the sole purpose of an expedited MRI. For improved resource utilization, efforts were made to convert inpatient MRI appointments for patients who could safely be discharged home to urgent outpatient MRI visits.
The project team evaluated inpatient populations that could safely be discharged with their MRI study converted to an outpatient order and developed an alternative workflow whereby the ordering provider could indicate to the MRI team when a patient was considered appropriate for discharge and place a STAT outpatient order for expedited imaging at one of our Ambulatory sites. These efforts have resulted in 532 fewer bed days required for the targeted patient population. This further resulted in our ability to care for 93 incrementally more patients. Tracking shows this project has had a positive financial impact to date of over $465,000. The project is ongoing, and remains extremely successful.