By Tracy Romanello, DO

In recent years, we have witnessed tremendous growth in the subspecialty of Palliative Care with its holistic approach to patient-centered care addressing vast physical, emotional, social, and spiritual needs. Through ongoing efforts to educate healthcare providers and the general community about early palliative interventions, the field is broadening its utilization of services from traditional associations with end-of-life care to a comprehensive approach enhancing quality of life for patients facing serious illness- at any age, stage and alongside life-prolonging treatments. While the paramount focus of palliative care is maximizing quality of life beyond mere disease management, secondary benefits of cost savings are realized, such as by reducing hospital readmissions, by minimizing unnecessary and burdensome treatments, and by allocating resources more efficiently.

CAPC, the Center to Advance Palliative Care, a national organization that in 2018 shared “The Case for Hospital Palliative Care- Improving Quality, Reducing Cost” found that on average palliative care consultation is associated with reductions of $3,237 per hospital admission, ($4,251 for cancer patients, $4,865 for those with > 4 diagnosis). CAPC also reports that for a mid-sized hospital conducting 500 palliative care consultations per year, this may represent savings of over $1.6 million per year.

Fragmented healthcare can lead to hospital readmissions that take a toll not only on patients and families, but also on healthcare systems. When root causes of readmissions are met by palliative providers devoting time to intensive patient and family meetings, then risks of readmissions are reduced. Also, in having meticulous attention to symptom management as a strong emphasis of palliative care, distressing symptoms, (i.e., breathlessness, pain, nausea) are optimally managed, thus reducing the likelihood of readmission for unresolved symptoms. Challenges that exist around psychosocial dynamics, unmet spiritual needs, poorly coordinated care, and non-adherence with treatment plans that lead to repeated hospital readmissions are addressed by palliative interdisciplinary team members contributing to a more streamlined, cost-effective healthcare experience.

Defining goals, values, and preferences for patients is another hallmark feature of palliative medicine. Open, honest communication is the cornerstone of patient-centered care, particularly when people are having a range of strong emotions such as sadness, fear, and anxiety during periods of complex medical decision making. Through facilitating discussions that respect dignity, autonomy, and informed choices, shared decision-making ensures medical interventions are aligned with realistic goals of care. This can help to avoid unnecessary or overly aggressive medical interventions that are not aligned with a patient’s wishes. A palliative approach supports emotional well-being and promotes quality, while reducing costs associated with unnecessary or unwanted treatments.

Efficiently allocating healthcare resources is crucial for enhancing population health. Palliative specialists often conduct communication under upsetting circumstances for patients and families, many times requiring lengthy, repeated discussions utilizing unique training and skills fundamental to their role. Tailoring treatment plans with patient-centered decision-making helps to ensure that resources are well allocated. Palliative care teams can guide appropriate Emergency Department and Intensive Care Unit utilization and assist with timely discharge to an appropriate care setting.

Palliative care is continuing to grow as a medical discipline, with more people having an interest in the field. Optimizing patient care in a supportive and nurturing healthcare environment is fulfilling and can promote overall wellbeing for providers who are tasked to deliver services under stressful, high-pressure situations common to today’s medical practice. Awareness of the many benefits of palliative care is emerging in literature, research, and data. This palliative-minded focus will continue to improve the quality of life for patients and families, while also offering cost-effective solutions and sustainability for healthcare systems.

Dr. Tracy Romanello is Medical Director, Catholic Palliative Care Services and Catholic Hospice. For more information, call 877-CHS-4ALL.