Carolinas HealthCare System

Restructuring Palliative Care Will Help Better Address Patients’ Needs

John Barkley, MD, FCCP
Chief Medical Officer of the System’s Continuing Care Division

Carolinas HealthCare System’s Continuing Care Division is focusing on an important sector of the patient population that drives a disproportionate share of healthcare spending – those with serious, advanced or terminal illnesses.

Each year, about 5 percent of the U.S. population accounts for about 65-70 percent of Medicare dollars spent – and over half this amount is spent during a person’s last 12 months of life. With 10,000 Baby Boomers becoming Medicare-eligible every day, this population of patients with complex illnesses is growing at a rapid rate.

 A recent addition to the continuing care field has been the non-hospice palliative care movement, which has been proven to:

  • Reduce pain
  • Lessen common physical symptoms (like shortness of breath) and psychosocial distress
  • Improve overall quality of life
  • Prolong survival for patients with serious or advanced illnesses

The System has active palliative care consult teams at nine hospitals and at three Levine Cancer Institute sites, with plans to expand. In 2013, palliative care consult teams saw more than 5,200 patients. This year the number is expected to surpass 6,000.

“As our population continues to age, facing more complex, chronic diseases, palliative care consultation rates are rapidly outpacing the number of specialists,” said John Barkley, MD, FCCP, chief medical officer of the System’s Continuing Care Division.

The System has begun to implement changes that will ensure basic palliative care needs can be handled by all providers, nurses and teammates who care for patients with serious, advanced or terminal illnesses. This reserves palliative care specialists for the more complex patients.

"Generalist palliative care" is being implemented through Integrated System of Care as another method to provide seamless care for patients across the full care continuum. Providers will learn more about this initiative through standardized education, trigger tools, algorithms, checklists and more.

"This new paradigm of care will take time to become the norm, but I am confident that all providers want to deliver the very best care they can for their patients,” Dr. Barkley said.