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How to Establish a Palliative Care Program

Sell the Plan

Institutional commitment for the plan is obtained through regular and careful communication. Share information with key leaders and stakeholders at each step of the process:
  • Needs assessment. Create the awareness of a need for change by involving them and sharing tools and data.
  • Strategic plan. Communicate early and often about what you are proposing. Circulate a draft to key people before it is formally presented. In planning a formal presentation, anticipate whose support will be necessary to enable moving forward. Consider practicing your presentation beforehand.
  • Implementation. Keep key people informed about progress.
  • Evaluation and quality improvement.Evaluation and quality improvement. Let decision-makers know what is being achieved relative to the needs assessment and strategic plan.
  • Plans for revision and growth.Plans for revision and growth. Communicate when key decision points are near and when the next phase of planning will occur.

Use different types of information. The needs assessment will yield both quantitative and qualitative data. Use both. Compelling real patient care situations communicate compelling need and what could be accomplished if there were a palliative care program in place in ways that data and graphs cannot.

"We received no written information from the doctor."

"We learned about the disease through experience as we went along."

"We only received social services because I went looking and asked."

"I need help venting my angry feelings. Help dealing with the guilt of feeling this way."

Ref: Glajchen, M, Portenoy RK, Blank A. Educating Caregivers about Pain Management: A Pilot Program for Caregivers of Patients with Sickle Cell Disease and Rheumatoid Arthritis. Poster Presentation, the 17th Annual American Pain Society Meeting, 1998

Selling the plan requires:

  • Champions
  • Advocates
  • Implementers-they may not be champions but are respected as folks who can get the job done
  • A process for communicating effectively with important decision-makers

Determine what approval means. What will constitute acceptance? There may be parts of the plan that can be implemented because no one opposed it.

Can a trial demonstration project be negotiated?

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

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Next Page Phase 3: Implement the Program


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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