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How to Establish a Palliative Care Program

Goals, Objectives

The exercise of writing goals and objectives helps to focus how the mission and vision will be achieved.

Goals

Goals are usually listed in bullet or outline form. They are specific and measurable components that, if met, will mean that the program is successful and the mission and vision achieved.

Articulate both short-term goals (the next 12 months) and longer-term goals (3-5 years).

Some possible goals might be:

  • 70% of patients will have pain less than 4 (1-10 scale) within 48 hours after 6 months.
  • Housestaff will show 20% improvement on a test of palliative care knowledge after 4 years.
  • patient/family satisfaction will improve within 2 years.
  • physicians will express satisfaction with the palliative care program after 3 years.
  • we will care for 40% of patients who die in our hospital after 2 years of operation.
  • Revenue will meet direct expenses within 5 years.

Objectives

For each goal, there is a series of objectives that needs to be achieved in order to reach the goal.

For example, for goal of 70% of patients will have pain less than 4 (1-10) scale within 48 hours after 6 months. Objectives might be:

  • A chart review will be completed within one month to determine current percentage of patients who meet this criterion.
  • A palliative care consultation team will begin operating within one month
  • The nurse member of the palliative care consultation team will engage each nursing unit with pain management education within 3 months.
  • The physician member of the palliative care consultation team will present pain education as part of Grand Rounds within one month, and will present plans for consultation service to the Medical Staff.
  • Bedside charting forms will be modified to record pain scores with vital signs within 2 months.
  • Nursing policies and procedures will be revised to reflect best practice within 4 months. This will include steps to take if pain scores remain elevated.
  • The pharmacy will be able to provide dosing and opioid conversion guidance in the same way it does for antibiotics within 2 months.

Strategies and tactics can be described in order to achieve each objective.

CAPC Resources:
Additional resources on "Preparing a Business Plan"

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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

Development
Select section:
Change, Groups, Phase 1, 2, 3, 4

•  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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