News Release

University of Washington Schools of Medicine and Nursing and Harborview Medical Center Awarded $371,150 Grant for Innovations in Palliative Care in Intensive Care Setting

Project Will Improve Quality of Palliative Care for Patients and Their Families in Seven Intensive Care Units (ICUs)

March 3, 2003

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MISSOULA, MT – The University of Washington Schools of Medicine and Nursing today received a 3-year grant from The Robert Wood Johnson Foundation; the nearly $375,000 grant was awarded through the Foundation’s Promoting Excellence in End-of-Life Care program. The project will use the funds to improve the quality of palliative care for all patients and their families in seven distinct ICUs (Medical, Trauma, Neurosurgical, Burn, Surgical, Coronary and Pediatric ICUs).

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.”

The University of Washington 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.)

J. Randall Curtis, M.D. and Patsy D. Treece, R.N., are co-Principal Investigators for the project. Dr. Curtis describes the demonstration model, “We propose to implement and evaluate a multi-faceted, interdisciplinary but nurse-focused, quality improvement intervention to improve the quality of palliative care in the ICU. We are excited about the prospect of combining the many and diverse talents at our institution in a coordinated effort to produce a state-of-the art program that could be generalized to other institutions.”

The improvement intervention will be sited at Harborview Medical Center, a 350-bed county hospital within the University of Washington system in Seattle. Patients in the seven ICUs represent a diverse group from the standpoint of critical illness, chronic illness and ethnicity.

The five-component intervention includes clinician education about the principles and practice of palliative care, unit champions to promote attitudinal change and role modeling concerning palliative care, feedback of quality improvement data to clinicians and implementation of systems-level support to improve care and enhance sustainability of the program. Clinicians involved in this project include nurses, physicians, social workers, respiratory therapists and chaplains.

“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.