Comprehensive Cancer Center, University of Michigan

Project Overview

Researchers at the University of Michigan's Comprehensive Cancer Center, in conjunction with Hospice of Michigan, four large medical centers and physicians' practices, studied the benefit of introducing hospice care to people earlier in the course of a progressive, incurable illness. Via a randomized clinical trial, the  Palliative Care Program, in Ann Arbor, Michigan, demonstrated that patients receiving treatment to fight their illnesses can enjoy a better quality of life if they receive hospice care before the final weeks of life. Patients typically receive no hospice care until all life-prolonging options have been exhausted, often within just two weeks of death.

Dr. Kenneth J. Pienta, who directed the project, believed the new system allowed patients and their families to more easily prepare for the end of life, and was cost-effective at the same time. "Within this system the patient and family could appropriately begin the process of transition and we could provide an opportunity for patients and families to grow through the end of life," Pienta said. This University of Michigan program integrated hospice into the plan of care for patients with advanced breast, prostate or lung cancer or advanced congestive heart failure while life-prolonging treatment continued. It provided regional and national health care planners with valuable data concerning the costs of merging curative or life-prolonging medical care with hospice and palliative, or comprehensive comfort and supportive care.

The University of Michigan Cancer Center is a National Cancer Institute Comprehensive Center.

Tools

• Hospice of Michigan: Caregiver's Manual
• Integrating Palliative Care and State-of-the-Art Cancer Care
  The University of Michigan Cancer Center and Hospice of Michigan are profiled in the Financial Implications of Promoting Excellence in End-of-Life Care monograph.

Related Resources

This demonstration project was featured at the 2003 NHPCO 18th Management and Leadership Conference:

• Session 1: Concurrent Care - New Models and Successful Strategies for Aligning Access, Quality and Costs.
• Session 5: Integrating Palliative Care and Cancer Treatments: Successful Partnerships between Hospices and Cancer Centers
• Session 7: Moving Hospice Care Upstream: Expanding Palliative Care

After the Grant

This project, a randomized control trial, was designed to be discontinued when the grant ended.

Contact Information

Principal Investigators:
John Finn, M.D.
Hospice of Michigan
400 Mack Ave.
Detroit, MI 48201
Telephone: 313.578.5029
Fax: 313.578.6391
Email: jfinn@hom.org

Kenneth J. Pienta, M.D.
Associate Professor
University of Michigan
Internal Medicine and Surgery
1500 East Medical Center Drive, 7303 CCGC
Ann Arbor, MI 48109-0946
Telephone: (734) 647-3422
Fax: (734) 647-9480
Email: kpienta@umich.edu

Web site: www.cancer.med.umich.edu

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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.