End-of-life care

Innovations

Creation of Households Program in Nursing Home Improves Residents' Health Status, Reduces Staff Turnover, and Boosts Demand for Services 04/09/08

Meadowlark Hills, a retirement community, renovated one of its facilities so residents can live together in group households and become more independent. This led to improved residents' health and a sharp decrease in staff turnover.

Nursing Home "Neighborhoods" Emphasize Dignity and Independence, Leading to Improvements in Resident Health and Quality of Life and Lower Employee Turnover 03/17/08

Providence Mount St. Vincent (known as “The Mount”) developed and implemented a new model for nursing home care in which most residents live in a “neighborhood” of 20 to 23 residents; neighborhoods contain a cluster of private and semiprivate rooms and a large kitchen/dining area that serves as the central gathering spot for meals and activities. The Mount's approach also focuses on giving residents more independence, autonomy, and dignity than in a traditional nursing home, leading to a greater sense of community and a higher quality of life for residents, as well as a better work environment for employees.

Staff Training and Support, Incentives, and Feedback Fails to Generate Sustainable Reductions in Pressure Ulcers at Nursing Home 03/05/08

Guided by a university research team, a 136-bed, not-for-profit nursing home in Pennsylvania implemented a quality improvement program to reduce pressure ulcer incidence. The program included three components: education and tools to increase workers' ability to recognize and prevent pressure ulcers; financial incentives for improved performance; and ongoing performance feedback.

Home-Like, Self-Directed Environment Provides Superior Quality of Life Than in Traditional Nursing Homes and Assisted Living Facilities 02/21/08

THE GREEN HOUSE ® model provides elders with an alternative to nursing homes and traditional assisted living facilities.

At-Home Palliative Care for Veterans Enhances Medication Adherence and Connections With Families and Providers, While Also Lowering Costs 02/20/08

The Advanced Illness Palliative Care program is a multidisciplinary initiative that provides care management and palliative care to chronically or terminally ill veterans in their homes via telehealth technology.

Palliative Care Nurses in Primary Care Clinics Reduce Hospital Admissions, Increase Use of Hospice and Home Care for Patients Nearing End of Life 01/15/08

A partnership between a hospice organization and an 11-location multispecialty group practice places palliative care nurses in primary care clinics to monitor dying patients' medical and social care needs, coordinate community services, and discuss end-of-life issues.

Comprehensive Palliative Care Program Improves End-of-Life Care and Pain Control for Terminally Ill Patients 01/08/08

Hoag Memorial Hospital Presbyterian established a comprehensive end-of-life program that includes pain control and emotional support for patients unlikely to survive the next few days; a multidisciplinary palliative care that assists physicians who are treating dying patients; compassionate care for parents who lose children before or after birth; and support for hospital staff who work with dying patients.

Comprehensive, Integrated Palliative Care Reduces Costs and Improves Satisfaction Among Patients and Their Families Within a Large Health System 12/05/07

Fairview Health Services' palliative care program offers palliative care clinical and support services to inpatients, outpatients, and home care patients to mitigate suffering and improve quality of life; the program is integrated into the care process to facilitate referrals and care coordination.

Nursing Home Learning Collaborative Improves Quality of Care, Reduces Staff Turnover 12/03/07

In an approach to improving nursing home care known as the “Wellspring Program,” nursing homes join an alliance that allows participants to exchange performance experience and conduct interdepartmental group training for both frontline staff and leadership on quality improvement and culture change processes.

House Calls to Frail Elders Reduce Costs, Hospital Use, and Nursing Home Placements 12/03/07

An interdisciplinary team of geriatricians, nurse practitioners, and social workers provide primary health care via house calls to homebound frail elders.

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