Emory aims to strengthen team-based palliative care
By Laura Raines
In exploring the palliative care specialty, I was pleased to discover leading experts and cutting-edge research happening right in our own backyard.
Starting her medical career as an emergency room physician, it didn’t take Dr. Tammie Quest long to realize that the ER could be a place of great suffering and death.
“I knew I lacked the training I needed to help patients at the end of their lives. I saw palliative care [specialized medical care for patients with serious illnesses] as a critical need in my work and dedicated my life to being a change agent for palliative care in emergency medicine,” she said.
Today, Quest is the director of the Emory Palliative Care Center , serving as chief of clinical operations in palliative care across Woodruff Health Sciences Center’s facilities and affiliates, such as the Atlanta VA Medical Center. She also leads the center’s development of research and education initiatives.
“More and more people every day are looking at palliative care as a key aspect in health care delivery,” she said. “We are seeing a shift to focus on quality of life.”
Research on quality of life issues and patient-centered outcomes has been growing for 10 years, Quest said.
“Meeting people where they are and supporting them is the most important thing we can do,” she said. “Research shows that people live longer and better with this kind of care. It’s a benefit, no matter what you are facing.”
For the next three years, Quest and geriatric nurse expert Carolyn Clevenger will be leading a collaborative training model made possible by a $1.5 million grant from the U.S. Department of Health and Human Services.
“We will be training nurse practitioner/physician teams in primary palliative care,” said Clevenger, DNP, GNP-BC, a clinical assistant professor with Emory’s Nell Hodgson Woodruff School of Nursing. “Noncommunicable diseases like cancer, Alzheimer’s or heart disease are our biggest disease burden now.
“We can no longer hope to serve all those patients with a tertiary, or consultative, palliative care service. We have to do better and take a different approach.”
Primary palliative care would deliver straight-forward information about disease trajectory and care planning at the onset of a patient’s disease, while at the same time delivering aggressive management of the disease.
The pilot program will train nurse practitioner/physician teams in six Emory Healthcare units and wards: leukemia, heart failure, hospital medicine, medical critical care, surgical critical care and neurology critical care.
“These nurses and physicians will be given added skill sets and knowledge about palliative care and they will also receive leadership training in teamwork and communication, because knowing what to do and influencing others to do it are two separate things,” Clevenger said. “We want them to influence change in their units.”
By moving palliative care to the forefront, Clevenger and Quest hope to change the culture in health care.
“We’ll be asking families if they felt well-informed and supported during care. The bottom line is that we hope to improve patient satisfaction in quality indicators,” Clevenger said.