The University of California is leveraging its expertise to enhance patient care at UC medical centers systemwide, awarding a $1 million grant to expand specialized care for seriously ill patients.
The two-year project, led by Wendy Anderson, MD, MS, of UC San Francisco, seeks to improve the quality of care for patients in the intensive care unit (ICU) and their families. The project will expand a training program for bedside nurses to increase the integration of palliative care into ICUs across UC Health.
Palliative care is specialized medical care for seriously ill patients and their families that focuses on quality of life: managing pain, symptoms and stress of serious illness, and helping to ensure that patients get the type of care they want. Palliative care improves care for patients and their families, and also decreases costs. While the field has been growing rapidly – two-thirds of U.S. hospitals with more than 50 beds now have a palliative care team – access is still limited. Even in hospitals that have palliative care, many seriously ill patients do not receive it.
The grant is being awarded by a new joint venture between the UC Center for Health Quality and Innovation and UC’s systemwide Office of Risk Services. The joint venture, called the Center for Health Quality and Innovation Quality Enterprise Risk Management, is part of an effort to improve patient care and satisfaction throughout UC Health.
“We are focused on transforming health care so that it improves the quality of the care we give, the efficiency of the care we give and improves population health,” said Terry Leach, executive director of the UC Center for Health Quality and Innovation. “I can’t think of a better example than to improve care to the seriously ill.”
The project, led by Anderson and her co-investigators, Steven Pantilat, MD, from the UCSF School of Medicine and Kathleen Puntillo, RN, PhD, from the UCSF School of Nursing, aims to increase the integration of palliative care in the ICUs of the medical centers at UC Davis, UC Irvine, UCLA, UC San Diego and UCSF.
ICU stays can be incredibly difficult for patients and families alike. Patients frequently experience pain and other symptoms, and may receive treatments that are not consistent with their wishes. Families often suffer from emotional distress both during and after patients’ ICU stays. When integrated into ICUs, palliative care can improve management of patients’ symptoms, decrease family members’ distress, help ensure that the care provided matches patient preferences and increase satisfaction. It also can support ICU providers and decrease ICU length of stay and costs.
Anderson, a UCSF assistant professor of medicine, received a UC innovation center fellowship last year during which she and the UCSF team trained 68 UCSF bedside nurses to provide palliative care in the ICU. This new grant will help establish a collaborative of ICU and palliative care nurse and physician leaders from throughout UC Health. It will expand a nurse training program for ICU bedside nurses and identify and implement best practices in ICU-palliative care integration across UC medical centers.
“The UC medical centers have world-class palliative care services,” Anderson said. “But palliative care isn’t routinely involved in the care of patients in the ICU. We want to make sure that every patient and family member in the ICU at all the UC medical centers has access to palliative care.”
The team plans to provide palliative care training to 600 bedside nurses at UC medical centers over two years and put in place systems to sustain and continue to expand the integration of palliative care into the care of seriously ill patients.