Palliative Care: Inpatient Consult

Goals and Objectives

To gain knowledge and experience providing inpatient palliative care.

Objectives

Patient Care:

  • Perform adequate assessment of history and physical exams of patients with advanced illness
  • Decide when a diagnostic test or procedure should or should not be used in this population
  • Develop differential diagnosis
  • Accurately communicate prognosis to patients and families
  • Appropriately manage physical symptoms, psychological issues, social stressors, and spiritual aspects of the patients and families
  • Appropriately respond to suffering by addressing sources of medical and psychosocial/spiritual distress
  • Demonstrate respectful attention to age/developmental stage, gender, sexual orientation, culture, religion/spirituality, as well as family interactions and disabilities
  • Maximize level of function and quality of life for patients and families
  • Provide education to patient and families
  • Recognize signs and symptoms of impending death and appropriately care for imminently dying patients and their family members

Medical Knowledge:

  • Assess and communicate prognosis
  • Recognize the presentation and management of common cancers and non-cancerous life-threatening conditions
  • Epidemiology, evaluation, prognosis, treatment, patterns of advanced or metastatic disease, emergencies, complications, associated symptoms and symptomatic treatments
  • Explain principles of assessing and treating pain and other non-pain symptoms

Practice-Based Learning:

  • Use evidence-based medicine to gain knowledge in the field of palliative medicine
  • Maintain safe and competent practice, including self-evaluation and continuous learning

Interpersonal and Communication Skills:

  • Gain empathy for and understand what patients and families go through when they have a terminal diagnosis
  • Facilitate discussions about advance directives and goals of care in this population
  • Run family meetings and communicate well with families of patients with advanced illness
  • Work well with an interdisciplinary team
  • Demonstrate ability to recognize and respond to one’s own emotions
  • Develop ability to educate patients and their families about the medical, social and psychological issues associated with a life-limiting illness
  • Use age, gender and culturally-appropriate concepts and language when communicating with families and patients
  • Develop and maintain effective relationships with referring physicians, consultant physicians and other health care providers
  • Maintain comprehensive, timely, and legible medical records

Professionalism:

  • Show integrity, respect and compassion for patients and their families
  • Achieve appropriate balance between the needs of patients and families and self care
  • Recognize own role and role of the system in disclosure and prevention of medical errors
  • Demonstrate accountability to patients, society, and the profession
  • Commit to excellence
  • Work cooperatively with the attending physician and interdisciplinary team
  • Demonstrate knowledge of ethics and the law that should guide the care of patients

System-Based Practice:

  • Learn what determines eligibility for palliative care