Few Hospital Palliative Care Programs Meet National Staffing Recommendations

Abstract

The predominant model for palliative care delivery, outside of hospice care, is the hospital-based consultative team. Although a majority of US hospitals offer palliative care services, there has been little research on the staffing of their program teams and whether those teams meet national guidelines, such as the Joint Commission's standard of including at least one physician, an advanced practice or other registered nurse, a social worker, and a chaplain. Data from the 2012-13 annual surveys of the National Palliative Care Registry indicate that only 25 percent of participating programs met that standard based on funded positions, and even when unfunded positions were included, only 39 percent of programs met the standard. Larger palliative care programs were more likely than smaller ones to include a funded physician position, while smaller programs were more reliant upon advanced practice and registered nurses. To meet current and future palliative care needs, expanded and enhanced education, as well as supportive financing mechanisms for consultations, are needed.

Palliative care use amongst patients with bladder cancer

“…To emphasise the widespread appropriateness of palliative care, recently released guidelines argue for early palliative care assessment for all patients with cancer . However, applying these guidelines may exacerbate a second cause for low subspecialty palliative care use: a critical shortage of palliative care providers . The current palliative care workforce can provide for only 25% of patients with palliative care needs, and this unmet need is projected to worsen .…”

The Effects of Nursing Satisfaction and Turnover Cognitions on Patient Attitudes and Outcomes: A Three‐Level Multisource Study

“…We expect supportive leadership predicts nurse satisfaction because it addresses autonomy, as nurses feel empowered to act independently in making decisions (Spetz et al. ); competence, as they feel well equipped with necessary resources; and relatedness, as they form relationships with leaders (Kottke and Sharafinski ; Hofmann and Mark ; Jokisaari and Nurmi ). In contrast, dissatisfaction‐based turnover cognitions are likely to ensue in the absence of leadership support, leading a nurse to consider leaving the organization in favor of a more intrinsically satisfying and supportive environment.…”

Follow the trail: Using insights from the growth of palliative care to propose a roadmap for cancer rehabilitation

“…Currently, the registry, which includes almost 1200 programs (registry.capc.org; accessed April 15, 2018), captures a nationwide picture of palliative care in practice and is used to influence national policy and standards. Registry data have demonstrated growth in palliative care in the United States, in the number of programs that meet recommended staffing standards, and in the current state of hospital‐based pediatric palliative care in the United States . Moreover, CAPC, in conjunction with the National Palliative Care Research Center and data from other organizations, produces the CAPC Report Card, which is a state‐by‐state report card on access to palliative care services in US hospitals.…”

“…Registry data have demonstrated growth in palliative care in the United States, in the number of programs that meet recommended staffing standards, and in the current state of hospital-based pediatric palliative care in the United States. [93][94][95] Moreover, CAPC, in conjunction with the National Palliative Care Research Center and data from other organizations, produces the CAPC…”