Demonstrating Palliative Care Value: During and After the COVID-19 Crisis

Palliative care teams are supporting patients, families, clinician colleagues, and provider organizations in myriad ways during the COVID-19 pandemic. We’ve gathered suggestions from the field for making sure that your palliative care expertise is recognized and well-utilized during this uncertain time.

• Set up a 24/7 “hotline” so frontline clinicians, especially those in the emergency department and critical care, can reach a palliative care professional quickly and easily
• Ensure that your team can consult on patient treatment and can assume responsibility for family communications. DO NOT offer coaching – offer direct patient care
• Document and bill for your encounters, even if by telehealth or telephone
• Deploy team members to home-based virtual visits, if capacity is available, to care for patients unlikely to benefit from hospitalization or whom are high-risk
• Collect patient, family, and colleague stories and quotes
• Offer emotional support services to exhausted or distressed colleagues
• “Institutionalize” processes to proactively identify patients for palliative care consults (triggers) drawing on lessons learned from the COVID-19 experience

• Participate actively in your organization’s daily preparedness planning; contribution areas include:
  • Public communications
  • Comfort treatment order sets
  • Homecare access and quality
  • Medication planning for shortages
• Round daily in critical care units, emergency departments, and other areas where patients are still using services - do not await referrals
• Assist with hospital and system efforts to strengthen discharge capacity, such as working with the hospices, home health agencies, and nursing facilities to ensure sufficient PPE and capacity
• Maintain patient care volumes!
• Ensure that team is proficient in telehealth and telephone visits, documentation and billing
• Reach out to clinicians caring for recently discharged and recently visited patients to collaborate on ACP conversations or follow-up
• Consider extending your services to new settings, such as nursing facilities and medical offices currently serving patients virtually; the palliative care team can do ACP or manage symptoms to avoid urgent care or emergency department visits during this time