News Release

Massachusetts General Hospital and Harvard Medical School Awarded $375,000 Grant for Innovations in Palliative Care in Intensive Care Setting

Project Merges Palliative Care Program with Medical ICU

March 3, 2003

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MISSOULA, MT – Massachusetts General Hospital and Harvard Medical School 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 merge a well-established palliative care program with a Medical Intensive Care Unit (ICU) at Massachusetts General Hospital, an urban, tertiary care teaching hospital affiliated with Harvard Medical School.

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 in End-of-Life Care 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.”

Massachusetts General Hospital (MGH) 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.)

The MGH Palliative Care Service (PCS) is one of the most experienced palliative care teams in the country. Members of the PCS team have joined with other clinicians at the hospital to form an interdisciplinary leadership team that will introduce patient and family centered palliative care practices into the Medical ICU and merge palliative care and critical care cultures.

Co-Principal Investigators for the project are J. Andrew Billings, M.D., and Adele Kelley, R.N. Dr. Billings describes their model, “We will identify, pilot and evaluate a series of practical, transferable and measurable interventions that will assure greater attention to the physical, psychosocial and spiritual suffering of all patients admitted to the Medical Intensive Care Unit and their families.”

All health professionals, as well as health profession students, will be exposed to palliative care practice, with the existing PCS serving as trainers and consultants. Cross training between the Palliative Care Service staff and ICU staff will assure training for the palliative care staff in the culture and practice of critical care medicine. The training includes, “role modeling about palliative care and relevant communications skills,” Billings explains.

“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 a new plane. The enthusiastic response to the call for proposals is evidence of the strong commitment among leaders in 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.