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Program goals

  1. Tier One Training - Improve the care of seriously ill patients, and their families, by building generalist palliative care knowledge/skills among physicians, nurse practitioners and physician assistants.
  2. Tier Two Training - Increase the level of awareness and interest in Palliative care through extended mentoring, tailored to the needs of one to two participants per year.

Program objectives

  1. Professionalism
    • reflect on personal and professional experiences and values related to care of the seriously ill or dying patient
    • recognize professional responsibility for identifying potential “points of contact” opportunities to affect the patient’s narrative about their illness and their experience
    • incorporate the patient narrative in formulating medical recommendations
    • reflect on personal/professional/system/cultural/patient challenges to engaging in discussions regarding transitioning care for patients with advanced, serious illness
     
  2. Patient care/Medical Knowledge
    • examine the differences between the traditional model of curative/palliative trajectory vs. palliative as a continuum of care
    • reflect on current strategies for prognostication
    • describe the importance of functional status as a prognostic indicator
    • review the trajectory of dementia and the prognostic indicators of progression toward end of life
    • demonstrate how to assess pain in order to establish realistic goals for analgesia
    • demonstrate safe opioid prescribing and titration
    • differentiate the differences between acute and chronic pain, physiologic tolerance, addiction and pseudo-addiction
    • reflect on the importance of looking at symptoms as clues to the experience of suffering in illness
    • outline how to assess common non-pain symptoms
    • describe treatment for common symptoms at end of life
    • outline a practical approach to determining decisional capacity in the clinical setting
    • identify the utility of advanced directives in the setting of illness progression
    • construct a strategy to address discrepancies between written directives and families/DPOA preferences
    • identify three criteria indicating that transitions are imminent and that a discussion of goals is needed
    • create a plan for symptom management and support for the patient and family when care is transitioning, in order to avoid further unwanted re-hospitalizations
    • identify four essential components to effectively creating a plan of care and support for the patient and family facing a care transition
     
  3. Interpersonal and Communication Skills
    • identify words and body language that promote effective communication
    • practice the concept of “Ask-Listen-Tell-Ask”
    • demonstrate the use of “words that work” in eliciting the patient story and in establishing goals of care
    • identify personal anxiety and barriers when communicating serious news
    • make a medical recommendation to match medical interventions to the goals of the patient (with a standardized patient)
    • practice/utilize a model for the patient and family meeting (with a standardized patient)
    • recognize and respond to patient cues (with a standardized patient)
    • outline the six steps in communicating serious news
    • demonstrate the use of silence as an essential communication tool when discussing serious news
    • identify a four step model for eliciting the patient story for both diagnostic and therapeutic purposes in goal setting
    • establish a differential diagnosis for anger in the clinical setting
    • identify three strategies to deal with anger in the clinical setting
    • describe the use of curiosity as a tool for changing our narrative about a situation
     
  4. Practice Based Learning and Improvement
    • differentiate the differences between curing and healing in person/family centered care
    • reflect on strengths and identify opportunities for growth in knowledge and skill in the care of patients with advanced, progressing illness or who are dying
    • develop a personal improvement plan for life-long learning
     
  5. Systems Based Practice
    • differentiate between specialist and generalist Palliative care and the reason for incorporating generalist palliative care into practice
    • describe the criteria for Hospice eligibility
    • outline services available to the Medicare hospice patient and family
    • recognize the myths and truths about the Medicare Hospice Benefit

Contact us

For more information please email Tammy Bhang, ARNP at TammyBhang@FHShealth.org.