Development of a Palliative Care Program
Palliative care programs develop in different ways.
In some organizations, an individual or a group "champions the cause" and persuades
the leaders of the need for a palliative care program. In other cases, institutional
commitment and senior administrators lead the development. The actual process that will
be most successful will depend on the history, culture and "readiness" of the host
organization, the individuals who lead it, and the community/healthcare system that it serves.
To successfully "prepare" the organization to accept and embrace the new program, those
who will lead the development will need an understanding of:
Once the idea to develop a new program has been borne, the actual development
process typically occurs in 4 relatively distinct and sequential phases:
Without a doubt, some programs develop in unique ways and become successful. For example,
a few services started when one person started seeing patients without any explicit
permission from organizational leaders. However, as a general rule, it is wise not to
make assumptions about the culture of your organization. Instead, ask questions of leaders
to determine the approach that has the highest likelihood of success.
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CAPCManual Attribution:
von Gunten CF,
Ferris FD,
Portenoy RK,
Glajchen M, eds.
CAPCManual: How to Establish A Palliative Care Program.
New York, NY: Center to Advance Palliative Care, 2001.
©
Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, CA
and
The Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY, 2001
Permission to reproduce for non-commercial educational purposes with display of
attribution and
copyright is granted.
Last updated: February 20, 2002
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Development
Select section:
Change, Groups, Phase 1,
2, 3, 4
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Change
In Individuals
In Organizations
Stages of Change
Awareness
Adoption
Implementation
Institutionalization
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Small Group Structure / Function
Leadership
Group Formation
Group Function
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Phase 1: Prepare to Plan
Potential of Planning Process
How Much is Enough?
Ensuring Impact
Form Initial Workgroup
Elaborate Initial Idea
Stakeholders, Customers
Need, Purpose of Program
Planning Questions
Planning Steps, Timeline
Resources Needed to Plan
Use of Consultants
Use of Retreats
Write Planning Proposal
Selling, Getting Approval
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Phase 2: Plan the Program
Form Planning Workgroup
Review, Revise Process
Strategic Planning
What is Strategic Planning?
Models
Steps
How Much is Enough?
Resources
Review Stakeholders, Customers
Conduct Needs Assessment
Company
Competition
Customers
Conduct SWOT Analysis
Case Study - United Hospital Fund
Define the Program
Purpose, Values
Mission, Vision
Mission
Vision
Service Delivery Model
Goals, Objectives
Strategies, Tactics
Strategic Decision Points
Business Planning
Case Examples:
Cleveland Clinic
University of Virginia
Organizational Structure, Leadership
Financial Plan
Implementation Plan
Human Resources
Physical Resources
Informational Resources
Community Resources
Operations
Evaluation
Marketing Plan
Targets, Timing
Write Proposal
Suggested Proposal Outline
Sell Plan
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Phase 3: Implement the Program
Staff Recruitment
Staff Training
High Functioning Team
Standards of Practice, Policies, Procedures
Clinical Evaluation
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Phase 4: Review Program, Revise Plan
Form Review Workgroup
Program Evaluation
Plan Evaluation
Continuous Quality Improvement
Utilization Review
Appropriateness of Hospitalization
Documentation
Pearls
Respond to Denials
Revise Plan, Further Development
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