The Palliative Care Program at Froedtert Hospital was organized in 1993 to provide clinical care to seriously ill patients at Froedtert Hospital, a 450-bed academic non-profit tertiary care hospital, the primary teaching hospital for the Medical College of Wisconsin. Clinical care is coordinated through a clinical consultation service, inpatient unit, and outpatient clinic; staffed by four physicians, four palliative care nurses, a psychologist, and palliative care fellows. Over 1100 new patients were seen in 2007. The clinical program is overseen by the Hospital's Palliative Care Committee which provides direction for quality improvement, staff education, and clinical guideline development. Extensive educational training to medical students, residents, fellows, and faculty is offered by the Program along with community outreach efforts. The Program was recognized by the American Health Association's Circle of Life Award in 2004.
The Palliative Care Consultation service was started in 1993 and currently sees 70-90 new patient consults per month from all hospital services. Fifty percent of patients have cancer as the primary diagnosis, the next most common diagnosis is a neurological disorder (dementia, stroke, Parkinson's disease, neurologic trauma). The remaining consults comprise one or more chronic organ system diseases, trauma, or post-operative complications. The most common reasons for referral are pain/symptom management and assistance in establishing the goals of care.
There are two separate consultation teams to manage the patient volume, each with an average daily census of 8-12; each team has a physician, nurse, and one or more student/resident/fellow trainees. The clinical psychologist sees patients and/or families from both teams in need of psychological diagnostic or counseling services. The team provides training for 3rd and 4th year medical students, Internal Medicine residents, Pain Clinic and Oncology fellows, the Palliative Care Fellow, and advance practice nurse trainees.
The consultation service works closely with each of the Internal Medicine, Oncology, Neurology and ICU teams for early patient identification. A new screening process is being piloted to facilitate both in-hospital goal setting and long-term advance care planning for Internal Medicine and Neurology patients.
The Palliative Care Program coordinates an inpatient palliative care ward (4NW at Froedtert Hospital), as part of a swing-bed mixed Internal Medicine/Palliative Medicine ward. Patients admitted to the palliative care ward have specialty level needs for complex pain/symptom management or complex family systems issues, or are imminently dying. All unit nurses are cross-trained in palliative care. A palliative care admission has priority over medicine admissions; there is no upper limit on the number of palliative care patients.
Unit admissions come directly from the Emergency Department, the Intensive Care Units, home hospice programs for inpatient acute care, or transfers from other hospital wards. The Palliative Care Consultation Team sees all unit patients, but remains a consult service. A palliative care suite is available for families, along with two family meeting rooms, and kitchenette facilities. Twice weekly interdisciplinary team meetings with nursing, social service, discharge planning, chaplaincy, and others helps to coordinate care.
The interdisciplinary outpatient palliative care clinic sees patients in the Courage Clinic at the Froedtert Cancer Center. Our team includes physicians, nurses, and a psychologist. Our outpatient team sees both cancer and non-cancer patients, and addresses the full spectrum of quality of life needs for patients facing advanced or life-threatening illnesses. These include pain and other symptom management needs, emotional and psychological problems, family support, advance care planning, and helping patients and families make difficult decisions about medical care in light of progressive illness. Patients can be referred by their primary physician or oncologist, or can self-refer. Call (414) 805-6821 if you are interested in being seen in our clinic or have a patient you would like to be evaluated in our clinic.
Psychosocial care is provided by all team members, who recognize that patients with life-threatening illnesses face great challenges relating to their own psychological integrity as well as psychosocial and environmental stressors. Jo Weis, PhD, provides specialist psychological assessment and treatment.