I'm off to celebrate Christmas with my family. I hope you and yours have a safe and blessed Christmas.
Luke 2
1In those days Caesar Augustus issued a decree that a census should be taken of the entire Roman world. 2(This was the first census that took place while Quirinius was governor of Syria.) 3And everyone went to his own town to register.
4So Joseph also went up from the town of Nazareth in Galilee to Judea, to Bethlehem the town of David, because he belonged to the house and line of David. 5He went there to register with Mary, who was pledged to be married to him and was expecting a child. 6While they were there, the time came for the baby to be born, 7and she gave birth to her firstborn, a son. She wrapped him in cloths and placed him in a manger, because there was no room for them in the inn.
8And there were shepherds living out in the fields nearby, keeping watch over their flocks at night. 9An angel of the Lord appeared to them, and the glory of the Lord shone around them, and they were terrified. 10But the angel said to them, "Do not be afraid. I bring you good news of great joy that will be for all the people. 11Today in the town of David a Savior has been born to you; he is Christ[a] the Lord. 12This will be a sign to you: You will find a baby wrapped in cloths and lying in a manger."
13Suddenly a great company of the heavenly host appeared with the angel, praising God and saying, 14"Glory to God in the highest, and on earth peace to men on whom his favor rests."
15When the angels had left them and gone into heaven, the shepherds said to one another, "Let's go to Bethlehem and see this thing that has happened, which the Lord has told us about."
16So they hurried off and found Mary and Joseph, and the baby, who was lying in the manger. 17When they had seen him, they spread the word concerning what had been told them about this child, 18and all who heard it were amazed at what the shepherds said to them. 19But Mary treasured up all these things and pondered them in her heart. 20The shepherds returned, glorifying and praising God for all the things they had heard and seen, which were just as they had been told.
Thursday, December 21, 2006
Tuesday, December 12, 2006
Palliative Care - What's all the fuss about?
Update: After writing this I felt I should add a word of warning here. Everything I talk about in this post is Palliative Care at its main intersection with hospice care. Palliative Care is a much bigger beast than I describe below; I am only dealing with Palliative Care through the eyes of the average hospice program. To learn more about palliative care as it looks today I'd start at Pallimed.
It's hard to spend much time with hospice type people these days without hearing some mention of palliative care. Not long ago the term palliative care referred to symptom control focused medical care. Thus, the sentence, "That nurse is an expert on palliative care" would mean that the nurse had great knowledge about symptom management and usually worked in the field of hospice. The same sentence today would mean something completely different. Let me try to define what palliative care is coming to mean in the hospice world.
Palliative Care, as it is used today, has also been called "chronic care" and "pre-hospice care". Neither of those names sound attractive, so Palliative Care has become the buzz phrase. The other two names actually do a much better job of defining what this really is. Palliative Care, in today's parlance, is a medical program or service designed to provide symptom control and increased quality of life for people with a incurable condition or chronic illness. Basically it is, or will be when the kinks are worked out and Medicare agrees to pay for it, home care for people who are sick but don't qualify for either of the currently recognized home care programs (home health and hospice).
Quickly here, let me make sure that makes sense. Home Health deals with patients who can be taught to care for themselves or who need "short term" help to recover from something. Hospice deals with patients who have a terminal illness and a doctor willing to certify that "given normal disease progression" have six months or less to live. Palliative Home Care deals with people who will not be cured but are outside that six month window.
What's all the fuss about? Palliative Care, when all the dust settles, will be popular among patients and provide cost saving to the healthcare industry. Those two things add up to the next big arm of the already huge healthcare industry. You hear about Palliative Care because people are trying to make sure that they are ready to jump on the train when it starts moving. The fuss is caused by people seeing the birth of the next billion dollar Medicare program. Or, more precisely, we have found out that Medicare is pregnant and likely to give birth to a new home care program. The gestation period will be a few more years, but when that new "entitlement" arrives there will be no shortage of people/companies who want to take it from infantcy to the big bucks it has in its future.
I'll talk more later about how different industries (hospitals, hospice, home health) are positioning themselves. Like I said, we have a few years before the real fun starts, but people are already very busy getting the nursery ready. This is going to be a huge change in the American medical system and very interesting show to watch as different healthcare providers attempt to position themselves as the logical home of Palliative Care.
It's hard to spend much time with hospice type people these days without hearing some mention of palliative care. Not long ago the term palliative care referred to symptom control focused medical care. Thus, the sentence, "That nurse is an expert on palliative care" would mean that the nurse had great knowledge about symptom management and usually worked in the field of hospice. The same sentence today would mean something completely different. Let me try to define what palliative care is coming to mean in the hospice world.
Palliative Care, as it is used today, has also been called "chronic care" and "pre-hospice care". Neither of those names sound attractive, so Palliative Care has become the buzz phrase. The other two names actually do a much better job of defining what this really is. Palliative Care, in today's parlance, is a medical program or service designed to provide symptom control and increased quality of life for people with a incurable condition or chronic illness. Basically it is, or will be when the kinks are worked out and Medicare agrees to pay for it, home care for people who are sick but don't qualify for either of the currently recognized home care programs (home health and hospice).
Quickly here, let me make sure that makes sense. Home Health deals with patients who can be taught to care for themselves or who need "short term" help to recover from something. Hospice deals with patients who have a terminal illness and a doctor willing to certify that "given normal disease progression" have six months or less to live. Palliative Home Care deals with people who will not be cured but are outside that six month window.
What's all the fuss about? Palliative Care, when all the dust settles, will be popular among patients and provide cost saving to the healthcare industry. Those two things add up to the next big arm of the already huge healthcare industry. You hear about Palliative Care because people are trying to make sure that they are ready to jump on the train when it starts moving. The fuss is caused by people seeing the birth of the next billion dollar Medicare program. Or, more precisely, we have found out that Medicare is pregnant and likely to give birth to a new home care program. The gestation period will be a few more years, but when that new "entitlement" arrives there will be no shortage of people/companies who want to take it from infantcy to the big bucks it has in its future.
I'll talk more later about how different industries (hospitals, hospice, home health) are positioning themselves. Like I said, we have a few years before the real fun starts, but people are already very busy getting the nursery ready. This is going to be a huge change in the American medical system and very interesting show to watch as different healthcare providers attempt to position themselves as the logical home of Palliative Care.
Wednesday, December 06, 2006
Clarifying my hospice quality dream
Quickly, let me clear something up from my last post on creating and emplementing a system of quality indicators. I have been acused of having a pie in the sky dream where every hospice in the land voluntarily tracks and reports information that it is not required to track and report. Honestly, if you have been reading this blog for long, you should know that I don't trust many hospices any farther than I can throw them. This entire blog exists because I believe there are many hospices who sacrifice quality and compassion for the sake of the almighty buck. With that in mind, you have to know that I do not expect every hospice in the nation to voluntarilly join in anything that doesn't benefit their bottom line.
In the previous post I didn't do a good job of explaning that I believe Medicare is going to force this type of system on us within the next 5-10 years. The day is coming when hospices will be required to report quality information, and until that day comes I do not expect anything near 100% participation in this project. My dream has two chapters. The first involves the National Hospice and Palliative Care Orginization creating a quality program that is acceptable to both hospices and Medicare. The second, has enough hospices voluntarilly joining that program to prove to Medicare that the program works. If my dream comes true, when Medicare decides to drop the bomb on us, and they are going to drop the bomb, we will have actually been the ones who created the bomb. Through taking control of this project, we can ease our own pain and create something worthwhile at the same time. That is my dream.
In the previous post I didn't do a good job of explaning that I believe Medicare is going to force this type of system on us within the next 5-10 years. The day is coming when hospices will be required to report quality information, and until that day comes I do not expect anything near 100% participation in this project. My dream has two chapters. The first involves the National Hospice and Palliative Care Orginization creating a quality program that is acceptable to both hospices and Medicare. The second, has enough hospices voluntarilly joining that program to prove to Medicare that the program works. If my dream comes true, when Medicare decides to drop the bomb on us, and they are going to drop the bomb, we will have actually been the ones who created the bomb. Through taking control of this project, we can ease our own pain and create something worthwhile at the same time. That is my dream.
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