Expanding palliative care services
The palliative medicine consult team evolved from the James Cancer Pain Consult Service, which started as a center in 2005 and became a division in 2012. The goal of the Pain Service was to assist physicians at the James Cancer Hospital to manage complex cancer pain and symptoms in their patients. The service was originally staffed by one pain specialist, Costantino Benedetti, MD and one nurse practitioner. This service also provided services in the ambulatory clinic two half-days per week.
Our Development in Palliative Medicine
In 2004, the James senior leadership acknowledged the need to expand the scope of the pain service to include palliative care services. The assistant executive director, Dennis Smith, and the program director for palliative medicine, Moira Kelsey, attended a three day seminar in May of 2004 offered by the Center for the Advancement of Palliative Care (CAPC) on expanding palliative care services in the hospital setting.
In August of 2005, administration supported sending a team of eight health professionals, including hospital administration, palliative medicine medical director, palliative care program director, nursing administration, strategic planning, finance, home health care and a program nurse practitioner to a Palliative Care Leadership Center. The team went to the Massey Cancer Center of Virginia Commonwealth University Medical Center to receive "hands-on" training to develop a palliative care program at the James Comprehensive Cancer Center. The need for a physician champion in palliative medicine was quickly recognized. Also, in order to support expanding the scope of the palliative care consult team, additional interdisciplinary team members were recruited.
In November of 2005, Michael Adolph, MD, a surgeon by training who had completed his palliative care fellowship at The James, came on full time as staff physician. In May of 2006, Robert M. Taylor, MD, was recruited from Mt. Carmel Health System. Mt. Carmel is a designated Palliative Care Leadership Center by the Center to Advance Palliative Care and Dr. Taylor was the medical director of Hospice and Palliative Care for Mt. Carmel. Additional team members were recruited including a second nurse practitioner, pharmacist, psychologist, chaplain, as well as two fellows. Fiscal year 2007 was the first full year the team worked together with the charge of expanding palliative care services within the James.
Our Center's Team
Due to the increase in volume of consults, the expansion of palliative care services to University Hospital and Ross Heart Hospital and additional ambulatory clinic time, additional staff were added to the service. Today's palliative care center team consists of one medical director, one nursing director, 12 attending physicians, one psychologist, 4 pharmacists, 14 advanced practice nurses, 2 out-patient management coordinator RNs, 2 social workers, 3 administrative support staff, 4 fellows and one part-time chaplain.