Palliative Care: Inpatient Consult Rotation

Goals and Objectives

To gain knowledge and experience providing inpatient palliative care.

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: