Case Study 1

    Dr. Wilson is a physician who owns the private practice where you work. She has provided primary-care services for over 20 years in a rural community. In this time, she has seen many patients and their families struggle to receive adequate palliative care. You have practiced collaboratively with Dr. Wilson for 5 years, and you are the only nurse practitioner on staff. To help expand the services offered and meet population needs, Dr. Wilson has asked you to lead a new palliative care program in the practice. During an initial investigation, you note that a trend of including palliative care in primary-care practices is on the rise. Creating a program that is efficient and effective will require you to gain the buy-in of the staff and other providers in the practice. With this in mind, you begin developing the program.

    Case Questions

    Why are primary-care providers (PCPs) best suited to provide palliative care for their patients?
    Dr. Wilson has given you the task of developing and managing the new palliative-care program. What do you need to do to ensure proper management of the program?
    To ensure that the palliative care program is delivered in a safe, comprehensive, effective manner, you compare your program with the standards for the provision of palliative care and the certification of providers of palliative care created by The Joint Commission. If your program meets the standards, what will it include?
    Before implementation of the primary-care palliative-care program, you ensure that the providers and staff within the practice are committed to care for patients at the end-of-life stage or with life-threatening illnesses. What ancillary providers must be in place to provide specific palliative-care services?
    After the program starts, some of the staff members are struggling with fulfilling their responsibilities. What are some common obstacles likely to be reported by your staff? What reminders can you provide to help them overcome these obstacles?

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