Promoting Excellence : PEACE: Palliative Care Clinic Referral Letter

Name:
University of Chicago PEACE: Palliative Care Clinic Referral Letter

Description:
A one-page letter to the physician of a patient who was seen at the Peace Palliative Care Clinic, summarizing the clinic evaluation and offering several recommendations.

Category:
Clinical Care Tools - Care Plan

Source:
Palliative Excellence in Alzheimer's Care Efforts (PEACE)
University of Chicago Medical Center
Section of Geriatrics (MC 6098)
5841 South Maryland Ave.
Chicago, IL 60637

Contact:
Gavin W. Hougham, Research Director
[email protected]

Greg A. Sachs, Chief, Section of Geriatrics
[email protected]

How the grantee used this instrument:
This letter informed the patient's referring physician that their patient was seen at the clinic, who accompanied them, a list of recommendations for care, and the date of the next visit. Each letter is customized to the specifics of each patient.

Keywords:
symptom management, assessment

To use this tool:
You may adapt this letter for your own clinical use without additional permissions.

References:
Adapted for the PEACE project by Deon Cox-Haley and Lisa Maillard.

To view this tool:
Left click on the download link to view the PDF document in your Web browser. Right-click on the download link to save the document to your computer.
pdf PDF 12 KB / 1 page (Viewing PDF files requires downloading and installation of the free Adobe Acrobat Reader.)

Posted August 2004

University of Chicago: PEACE overview page


# UCP11, type:care_plan


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. Visit PromotingExcellence.org for more resources.

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