MDNews - Greater Boston

Cover Feature dr. Clarkin and nurse practitioner Caroline Morse speak with a patient as part of daily palliative care rounds. between the hospital, nursing care facility and home settings," Dr. Carty recalls. "These patients experienced significant physical symptoms and psychological issues that remained unaddressed. They were often admitted to different physicians during the course of the year, leaving them with fragmented care plans and no one who could assess and treat symptoms over time. This is why I chose to receive additional training in and become board certified in hospice and palliative medicine." In contrast, the palliative care team at Good Samaritan is able to meet with patients and their families before they face a crisis. This helps ease the process of assessing patient goals and values and guiding the decision-making process before difficult choices need to be made. The team can improve symptom management because they get a baseline understanding of the patient outside the parameters of their illnesses. In outpatient or inpatient settings, this allows the palliative care team to have a genuinely positive impact on patients and their families. Dr. Clarkin believes the discipline of palliative care will only become more important in the years ahead as the population ages, the prevalence of chronic diseases increases and the five-year cancer survival rate improves. These factors will increase demand for palliative care. "Palliative care is becoming a requirement for all hospitals," she says. "At Good Samaritan, we have the support of senior M O L ST leadership, and they understand that over time, we can improve quality of care for patients, and reduce stress and unnecessary costs because patients won't be in and out of the hospital." Community hospitals like Good Samaritan are in a particularly strong position to support and grow palliative care programs. They will enable patients to stay close to home by providing services directly to patients and their families, as well as educating clinicians about the benefits and usage of palliative care services. In the future, palliative care teams will be able to provide patients and their families with everything they need to ensure their own goals of care are respected. "This is almost like old-fashioned medicine, in which we go to patients' homes and get to know them better," Dr. Clarkin says. "Palliative care is a detailed approach that helps patients live better and longer, and it respects their rights." For more information about the Palliative Care Prog ram at Good Samaritan Medical Center, please visit www.steward.org/Good-Samaritan or call 508-427-2217. ■ Medical Center. "the MoLst form allows those preferences to be articulated within an order, much like a prescription." maSSachuSettS iS workinG to aggressively implement MoLst is being rolled out throughout Massachusetts following a the Medical orders for Life-sustaining treatment (MoLst) two-year trial program in Worcester. the commonwealth's MoLst form. these written instructions on a medical order form cover team is spreading implementation and striving to have clinical MoLst life-sustaining medical treatments from a clinician to other health champions in each hospital. it uses webinars and educational sessions professionals based on the patient's own stated preferences. to train the champion, who can then bring MoLst into the hospital on Wider use of the MoLst form will allow patients and physicians to a wider level. document choices and help ensure these decisions become orders that can be acted on outside the hospital. "at steward, i am the clinical champion for the system, and there is a clinician at each hospital who is responsible for championing steward health Care system is one of several organizations MoLst along with me," dr. Carty says. "We've done training in all throughout Massachusetts starting to integrate MoLst into their of our hospitals — as well as within the local chapter of our health operations and working to ensure patients and physicians understand system network — on what MoLst is, how the form is filled out and how to best use the form. how it is read. We've been able to implement it into our workflow so Perhaps the most important part of the process is engaging with clinicians earlier in the treatment of patients to ensure that they have conversations about patient preferences regarding the kind of care they want to receive when facing advanced illnesses or injuries. "People want to be sure that when they express their preferences that anyone who has limits on what kind of treatment they want has a signed MoLst." While steward is not yet at 100 percent implementation, dr. Carty says the hospital system is building MoLst into its quality score metrics. she is confident that the organization will continue to make they will be honored wherever they are in the care continuum," says 8 MoLst a priority because of the important role it plays in spelling out Marcy Carty, Md, vice President of Medical affairs at Good samaritan patient goals and preferences. | Greater Boston MD News ■ mdnewS.com

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