News Release

Lehigh Valley Hospital and Health Network Awarded $375,000 Grant for Innovations in Palliative Care in Intensive Care Setting

Project Will Develop a Palliative Care Model in Three Intensive Care Units

March 3, 2003

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MISSOULA, MT – The Lehigh Valley Hospital and Health Network (LVHHN) today received a 3-year grant from The Robert Wood Johnson Foundation; the $375,000 grant was awarded through the Foundation’s Promoting Excellence in End-of-Life Care program. The project will use the funds to implement and evaluate a palliative care model in three Intensive Care Units (ICUs) – Medical ICU, Surgical ICU and Acute Care Unit – in this academic community hospital. LVHHN is a major clinical campus for Penn State University’s College of Medicine, and has affiliations with local nursing and allied health schools and a physician assistant program.

Although many Americans receive highly skilled, state-of-the-art care in ICUs, experts increasingly recognize that critically ill patients also can benefit from palliative services. The Promoting Excellence program supports demonstration projects that integrate high-quality palliative care services in ICUs, improve care for critically ill patients and their families and assess the effectiveness of the interventions.

Ira Byock, M.D., a pre-eminent palliative care physician at The University of Montana, and Director of the Promoting Excellence national program, explains the need for the demonstration projects, “For too long, critical care and palliative care have been viewed as polar opposites. In reality, the science and skills of both disciplines are needed to provide optimal care for critically ill or injured patients and their families.”

The Lehigh Valley Hospital and Health Network is one of four grantees across the nation selected by The Robert Wood Johnson Foundation for funding from a highly competitive pool of 242 applicants who responded to the “Promoting Palliative Care Excellence in Intensive Care” call for proposals. (See attached list of grantees.)

LVHHN’s project proposes a cultural change that fuses palliative care practices with ICU practices. The intervention will be first introduced and refined in the Medical ICU, and then implemented in the Surgical ICU and Acute Care Unit, using a quality improvement format.

Co-Principal Investigators for the project are Daniel Ray, M.D. and Gretchen Fitzgerald, B.S., M.S.N. Dr. Ray explains, “Using components and processes such as interdisciplinary rounding (with pastoral care and optional family participation), palliative/curative care planning (within 24 hours of admission) and formalized patient/family shared decision-making, each admission to the ICU will be provided the education and support needed to improve the quality of experience in the ICU for patients and their families – in medical, psychosocial and spiritual domains.”

Other key components of the project include educating the ICU staff in palliative care practice, adding a palliative care nurse specialist to the ICU staff, an innovative computerized training for nurses, introducing clinical triggers that will imbed palliative care practices in the ICUs and revamping performance evaluations to include competency in palliative care.

“This Promoting Excellence initiative seeks to integrate attention to comfort and quality of life within state-of-the-art critical care,” says Byock. “In so doing, we hope to elevate best practice standards of critical care to advance the human values of comfort and emotional and spiritual caring within the high-tech environment and high-pressure pace of ICU practice.”

The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation’s largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse – tobacco, alcohol and illicit drugs.

GRANT RECIPIENTS

PROMOTING EXCELLENCE IN END-OF-LIFE CARE

Lehigh Valley Hospital and Health Network, Allentown, Pa. $375,000
Contact: Daniel Ray, M.D., Phone: 610.402.8499

Massachusetts General Hospital and Harvard Medical School, Boston $375,000
Contact: J. Andrew Billings, M.D., Phone: 617.724.9197

University of Medicine and Dentistry of New Jersey, New Jersey $374,770
Medical School, Newark, N.J.
Contact: Pat Murphy, Ph.D., A.P.N., F.A.A.N., Phone: 973.972.7251

University of Washington Schools of Medicine and Nursing, $371,150
Harborview Medical Center, Seattle, Wash.
Contact: J. Randall Curtis, M.D., M.P.H., Phone: 206.731.3356

For more information contact Karyn Collins at karyn.collins@mso.umt.edu or 406.243.6668.

Promoting Excellence in End-of-Life Care is a national program supported by The Robert Word Johnson Foundation, with direction and technical assistance provided by the Practical Ethics Center at The University of Montana.

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Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families.