DHMC Palliative Care PEER OBSERVERSHIP PROGRAM for Clinical Colleagues in Northern New England

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1 PALLIATIVE CARE SERVICE DHMC Palliative Care PEER OBSERVERSHIP PROGRAM for Clinical Colleagues in Northern New England PROGRAM DESCRIPTION AND APPLICATION FORM Program in Effect: September 20, 2010 to June 1, 2012 Please Note: Capacity for this tuition free education program is limited. You are encouraged to apply early.

2 PROGRAM DESCRIPTION This Peer Observership Program supports visiting clinicians in further developing their expertise in specific aspects of palliative care including: advanced pain and symptom management; communication strategies and approaches to psychosocial and spiritual counseling; and decision making support for patients and families confronting difficult treatment options. The program applies principles of adult learning in providing opportunities for clinicians to observe and learn from the active, seasoned palliative care team at DHMC through peer to peer modeling, complemented by providing access to carefully selected readings, quick reference charts and tips. Specific resources for clinical care and program development are provided, including clinical protocols and strategies for approaching common programmatic problems. In addition to these components, the macro context of the Observership experience conveys the efficiencies and effectiveness of practicing within an authentic interdisciplinary team. The schedule of visitors days ensures time for reflection and conversation with the DHMC faculty, and fosters the development of relationships for ongoing collegial interactions. PROGRAM OBJECTIVES The objectives of the program are to: Accelerate programmatic development of palliative care teams based in hospitals and in community hospice programs throughout the region; Enhance clinical knowledge and skills, and sophistication in the delivery of palliative care to patients throughout the region; Strengthen relationships among regional colleagues by fostering a vibrant palliative care learning community and network for collaborative quality improvement initiatives; Explore specific opportunities for collaboration in quality improvement and research projects. WHO SHOULD ATTEND The Peer Observership Program is specifically geared for: Hospitals and local health systems seeking to serve patients through hospital based palliative care programs; and Hospice teams seeking to provide palliative care in the hospital and nursing home settings. Specific disciplines include: Physicians, nurses, associate providers (nurse practitioners and physician assistants), social workers and chaplains; and Administration and management professionals with direct responsibility for planning or managing a palliative care program are also invited to participate as key team members. DHMC Palliative Care Peer Observership Program September 2010 to June

3 CURRICULUM TOPICS CLINICAL CONTENT Assessment and management of pain and non pain symptoms Medical and neuro psychiatric co morbidities in advanced illness Communication regarding serious illness and clarification of goals of care Counseling regarding adaptation to serious illness and issues of life completion and closure Ethical and legal decision making Assessment of quality of life Spiritual assessment and spiritual care in advanced illness Psychosocial assessment and support Practical and emotional support for families, including family caregiving Bereavement support for the family Death and dying across cultures PROGRAM DEVELOPMENT CONTENT Strategic planning and program development Key components of a business plan Systems and regulatory issues in hospice and palliative care Interdisciplinary team dynamics Effective collaboration, team work and self care The role of Healing Arts, Support Services and Volunteers in palliative care Outpatient clinic based palliative care Palliative care quality improvement and research methodology FACULTY Ira R. Byock, MD Sharona Sachs, MD Frances C. Brokaw, MD, MS Diane M. Palac, MD Marie A. Bakitas, APRN, DNSc, FAAN Margaret F. Bishop, APRN, MSN Paula A. Caron, APRN, MS, AOCNP Lisa A. Stephens, MSN, APRN Linda F. Piotrowski, MTS Donna L. Soltura, MSW Terry Fisher, MPH Wendy J. Sichel, MEd Deborah J. Steele, MA Briane M. Pinkson, LPN, LMT Yvonne J. Corbeil, RN Director, Palliative Care Service Professor of Anesthesiology and Community and Family Medicine CME Program Director Director of Clinical Services Professor of Anesthesiology CME Program Co Director Assistant Professor of Anesthesiology and Medicine Assistant Professor of Medicine Assistant Professor of Medicine and Anesthesiology Instructor of Anesthesiology Instructor of Anesthesiology Nursing CEU Program Director Instructor of Anesthesiology Spiritual Care Coordinator, Palliative Care Service Continuing Care Manager, Palliative Care Service Manager, Palliative Care Service Manager, No One Alone Volunteer Program Manager, Support Services Programming, Norris Cotton Cancer Center Healing Arts Practitioner Director of Network Development for Palliative Care Instructor of Anesthesiology and Community and Family Medicine DHMC Palliative Care Peer Observership Program September 2010 to June

4 PROGRAM SCHEDULE The program is being offered 7 months of the year over a two year period: 2010 Sept, Oct, and Nov 2011 Feb, Mar, Apr, May, Sept, Oct and Nov 2012 Feb, Mar, Apr and May The program will be offered the last two weeks of each month in session, with the exception of November when it will be offered one week earlier in the month to avoid Thanksgiving week. The program is offered in one or two week blocks. The latter is offered in two contiguous weeks and presents more time for in depth clinical exposure and consolidation. A maximum of 2 clinicians will be accepted into the program at any one time. Where possible, visits in pairs (i.e., two clinicians from the same program) are highly recommended. Capacity is limited. Early application is encouraged. TUITION AND FEES Due to the generous support from Jane s Trust, there are no tuition fees for this educational program. However, successful applicants will be required to provide a $300 commitment fee at the time that Peer Observership dates are confirmed. The full amount of this fee will be refunded upon successful completion of the program. Any un refunded monies will be added to the travel stipend fund for other candidates. Successful applicants are fully responsible for all travel, meals and accommodation expenses. They are also responsible for making their own arrangements. A listing of local accommodations and dining options is available upon request. TRAVEL STIPEND AWARDS As part of the supporting grant, Jane s Trust has allocated modest funds to assist participants who would otherwise have difficulty doing so. The primary focus of these stipends is support for clinicians and administrators who are charged with developing new or enhancing existing Palliative Care Programs within their organizations. Preference will be given to applicants from smaller rural hospitals (under 50 beds) and particularly critical access hospitals. ACKNOWLEDGEMENT Funding for this two year DHMC Palliative Care Service Peer Observership Program for Clinical Colleagues in Northern New England is generously provided by Jane s Trust. FOR MORE INFORMATION For more information on the Peer Observership Program, the Application Procedure, Scheduling or the Travel Stipend Awards contact Yvonne Corbeil at Yvonne.J.Corbeil@Hitchcock.org or DHMC Palliative Care Peer Observership Program September 2010 to June

5 PALLIATIVE CARE SERVICE DHMC Palliative Care Peer Observership APPLICATION FORM The completed application form and required supporting documents CAN BE SENT ELECTRONICALLY to or mailed to: Yvonne J. Corbeil, Program Director DHMC Palliative Care Peer Observership Program Dartmouth Hitchcock Medical Center One Medical Center Drive Lebanon, NH Demographic Information: Name: Title: Organization: Mailing Address: Phone: 2. In 300 words or less, describe what you hope to gain from participating in the DHMC Palliative Care Peer Observership Program: (Note this part of the application will carry the most weight with the review committee) 3. Describe your Palliative Care experience to date: DHMC Palliative Care Peer Observership Program September 2010 to June

6 4. Briefly describe your organization: 5. Does your organization/institution have an existing Palliative Care Program? Y N _ If yes, describe briefly: If no, is one being planned? Y N _ If yes, describe current plans: 6. Please provide the following additional documents: (Note documents may arrive separately) a. CV b. Letter of support from CEO of your organization c. Letter of support from your Medical Director (for physicians), Nursing Director (for nurses) or appropriate Department Head for other disciplines 7. This application is for: The ONE week program The TWO week program 8. Preference for scheduling: (Note see Program Schedule section for options) 1 st Choice: 2 nd Choice: 3 rd Choice: Additional comments re scheduling availability: 9. Do you plan to attend with a colleague? Y N _ If yes, please provide name: (Note a complete separate application from this individual is required) Applicant s Signature : Date: (Note electronic signature acceptable for electronic submission) DHMC Palliative Care Peer Observership Program September 2010 to June