Providence Trinitycare Hospice Foundation
PROGRAMS
Community Palliative Care
1. Community Palliative Care. Palliative care seeks to shelter patients with a chronic or progressive illness and treat their suffering broadly. Palliative care by definition is a ‘team sport’ and involves addressing all aspects of suffering, physical, spiritual, and psychosocial, striving to relieve suffering and improve quality of life. Palliative care can be offered at any stage of disease progression, whereas hospice is a defined benefit for patients in the final stages of life. We now have inpatient and outpatient palliative care programs for both pediatric and adult patients throughout LA and Orange Counties with over 1000 patients on service. One goal we had at the start of this program was to demonstrate and document for insurers the tremendous cost savings and patient benefits of palliative medicine. With positive data and metrics after a successful trial, work began with insurance companies to make this a permanent benefit. Unfortunately, Medicare does not yet reimburse for this benefit and philanthropy fills the gap in coverage as Providence’s government relations team works with Medicare for this to become a covered benefit nationally. Because of our work and the support on our local community, a palliative care benefit may emerge from the U.S. Centers for Medicare & Medicaid Services this year according to the National Hospice and Palliative Care Organization.
Outcomes we hope to continue to show as a result of continued growth of community palliative care include:
1) Over a two year period, there was a 30% reduction in ER visits among serious or chronically ill patients who enrolled in the community palliative care program
2) With enrolled patients, there was a 57% reduction in inpatient admissions.
3) Today, with more than 12 million American living with serious illness and this number is projected to double by 2040, the impact that palliative care could have on future patients and the health system throughout the U.S. is staggering.
These are documented metrics we were able to show Blue Cross/Blue Shield as they added palliative care as a benefit. Our community palliative teams include physician leadership to oversee and deliver outpatient services, a Registered Nurse to deliver direct patient care, a MSW to follow patients physically unable to travel to outpatient sites, and an administrative leader to ensure operational success. The caregiver team at Trinity makes a combination of home visits, office appointments, phone calls/telemedicine for assessment, intervention and care coordination most of the time with the patient never leaving their home.
TrinityKids Care
TrinityKids Care offers comfort and care to pediatric and adolescent patients, their parents, and to their immediate and extended family, the only provider in all of Los Angeles and Orange Counties. Our team works closely with parents and family to care for their child in the familiar and comforting surroundings of their home understanding the impact of a seriously ill child on the life of a family. The care and support required for a child with life-limiting illness and his or her family is far more complex than for an adult at the end of life requiring more modalities and plans of care than do the illnesses common in adults, including aggressive care up to the end of life. In addition, the length of illness varies widely in children because of differential development and resilience, and end-of-life care can extend over many years and through several developmental phases. Moreover, the range and intensity of emotions that parents experience as they navigate this territory are many they are unprepared to manage.
To meet the full scope and complexity of these needs, our interdisciplinary teams of physicians, registered nurses, social workers, home health aides, non-denominational chaplains, and volunteers are uniquely trained to care for children at the end of life and support their families. Our objectives are to provide the following services to all patients and families:
• Pain control, symptom management and end-of-life comfort care
• An on-call nurse, social worker and chaplain, 24 hours a day
• Hospice physician consultation
• Family counseling
• Emotional and spiritual support
• Help in obtaining medicine, supplies and equipment for the child
• Assistance with the child's practical needs such as feeding and bathing
• Supportive services for the child's siblings
• Grief and loss support
In addition, no one is turned away from TrinityKids Care to do lack of insurance or financial resources. Our Patient Care Assistance program (charity care) that is funded by philanthropy insures this.
Hospice Care
Hospice care of pediatric and adult patients/families in all of Los Angeles and Orange Counties. At TrinityCare, we understand that patients and their loved ones experience many conflicting emotions when facing serious illnesses. In these times of great need, our TrinityCare Hospice Program is devoted to families find peace. We provide a full range of hospice care and compassionate support to our patients and their families. By embracing a holistic and family-centered approach to hospice care, we work tirelessly to provide for every physical, emotional, social and spiritual care.
The Providence TrinityCare Hospice Palliative Program is an innovative team approach to how patients with life-threatening illness are supported and cared for during any stage of their illness. With physician leadership to oversee and deliver outpatient services, a Registered Nurse to deliver direct patient care, a Licensed Clinical Social Worker to follow patients physically unable to travel to outpatient sites, and an administrative leader to ensure operational success. The program team will make a combination of home visits, office appointments, and phone calls for assessment, intervention, and care coordination.
Additional patient and family support consists of:
1) Support transitions between care settings and closely coordinate plan of care with patients’ primary care physician
2) Comprehensive evaluation functional status, depression and home safety, individualized goals of care discussions, psychosocial and spiritual plan, ongoing patient, and caregiver education. Complete advanced directive/ POLST, education plan (Portable medical order form aka “POLST Form” that records patients' treatment and wishes).
3) Deliver Whole Person Care by interdisciplinary team using real time concurrent feedback from patients, families and clinical colleagues accompanied by weekly IDT (inter-disciplinary team meetings) a weekly debriefing process and review plan of care for each patient.
4) Provide support to patients & families via 24/7 phone Call Center staffed by clinicians Call center to addresses care needs, including symptom management.
5) Develop & conduct evaluations to assess patient & family satisfaction (every 3 months) and provider satisfaction (every 6 months).
6) Enroll patients in the program, coordinate and collaborate with their primary care physician, assessment / symptom management and follow up care in home, and medication management, 24/7 phone support, transition to hospice as appropriate.
No one is turned away from TrinityCare to do lack of insurance or inability to pay. A key element is designing treatment plans with an awareness of the social determinants of health affecting our patients, including their socio-economic status. Families often find their financial resources exhausted by a child’s long illness, especially since parents must often stop working to care for their child. TrinityKids Care conducts a family financial assessment to help ensure fundamental needs are met through “Necessities of Life” support (i.e. assistance with utilities, medical supplies, medications, transportation, and food).
CONTACT
Providence Trinitycare Hospice Foundation
5315 Torrance Blvd No B1
Torrance, CA 90503-4011