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How to Establish a Palliative Care Program

Conduct Needs Assessment

To answer the question, "Where are we now?" gather information in three broad areas:
  1. Host Healthcare Organization (Company). What is the current situation in the hospital?
  2. Similar Organizations (Competition). What are other similar institutions doing, both locally and nationally? Will the proposed program be inviting competition? Are there opportunities for collaboration?
  3. Customers. Assess the needs of those who will use the proposed services. At a minimum, the customers are potential referring physicians, other formal caregivers, patients, families, and the community served.

Studies and recommendations in the published literature will reinforce identified needs, findings and recommendations. As an example, the United Hospital Fund of New York sponsored a palliative care needs assessment in 12 acute care hospitals in New York.

The process of conducting a needs assessment creates a dialogue among staff in the institution, clarifies patient and family needs and encourages services tailored to meet these needs. By highlighting the disparities between care provided and the needs of patients and families, a tension for change is created.

Many people find that a SWOT analysis helps to identify and characterize the critical success factors for the proposed program.

CAPC Resources:
Additional resources on "How to Conduct a Hospital and Community Needs Asssessment"

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Help develop CAPCManual. Send your comments, questions, suggestions to: fferris@sdhospice.org
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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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