Palliative Care

Palliative Medicine Rotation Goals and Objectives

The special needs of patients with serious illnesses and their families are best addressed through dedicated training under the direction of experienced faculty with expertise in palliative care. By rotating with the palliative care consult team, the resident will have the opportunity to experience goal-directed therapy for patients. In addition, the resident will become familiar with the basic concepts of the delivery of hospice and palliative care in the inpatient setting. During this elective the resident is introduced to the multidisciplinary care for patients with serious illnesses and their families and will work closely with team members of other disciplines.

GOALS AND OBJECTIVES

The resident will learn skills, knowledge and professionalism necessary to practice competent and comprehensive care of patients with advance medical illness relevant to their field.

Learning Objectives:

Learning objectives while rotating through the Palliative Care Service; the resident is expected to:

1. Recognize the difference between hospice and palliative medicine.

2. Demonstrate the communication skills necessary for primary palliative care.

3. Recognize the range of skills and services provided by members of the interdisciplinary team.

4. Understand the key components of the Medicare Hospice Benefit.

5. Understand and manage advance care planning and FHCDA.

ROTATION COMPETENCIES:

Patient Care

The resident will:

1. Observe or perform (as determined by supervisor) accurate and complete medical interviews and physical examinations for patients with advanced chronic and terminal illness.

2. Obtain and evaluate relevant diagnostic data and identify and prioritize the medical problems of terminally ill patients.

3. Manage patients appropriately based on available evidence, sound judgment, and patient preferences.

Medical Knowledge

The resident will:

1. Demonstrate knowledge of the basic and clinical sciences appropriate for his/her educational level.

2. Demonstrate a comprehensive understanding of the common problems related to palliative medicine.

3. Demonstrate the ability to access relevant information related to palliative medicine.

Practice-Based Learning

The resident will:

1. Demonstrate the ability to self-evaluate his/her educational needs and performances.

2. Incorporate relevant constructive feedback and instruction into clinical activities of the rotation.

3. Use technology to enhance patient care and further his/her medical education.

Interpersonal and Communication Skills

The resident will:

1. Establish an effective therapeutic relationship with patients and families.

2. Demonstrate effective listening skills.

3. Demonstrate effective patient education and counseling skills.

4. Use effective and appropriate nonverbal communications with patients and their family members.

Professionalism

The resident will:

1. Consider the needs of patients and families appropriately.

2. Consider the needs of colleagues (physicians, nurses, other health care professionals, and administrative staff) appropriately.

3. Acknowledge errors and participate to efforts to discuss and report.

4. Fulfill responsibilities expected from their level.

5. Demonstrate ethical behavior.

Systems-Based Learning

The resident will:

1. Understand the context of how palliative care service and hospice care is provided within the larger health care system.

2. Understand the palliative care needs of the patients and refer to specialty care appropriately.

3. Access resources effectively.

4. Use systematic approaches to improve patient care and reduce errors.

TEACHING METHODS

Supervised Direct Patient Care: Learning on this rotation is patient-centered with supervised direct patient care making up the majority of the training experience. The experience is focused on providing compassionate and individualized care for hospitalized patients with serious illnesses. The resident will see and care for active patients on the Palliative Care Service.

Conferences/Meetings: The resident will participate in educational conferences/meetings while on this rotation as per divisional didactic calendar.

Assessment Tools

1. Attending feedback (formative)

2. Rotation Evaluation (summative)

FACULTY CONTACTS

Vanessa Lewis Ramos, MD: vlewisr@montefiore.org

Serife Eti, MD: seti@montefiore.org

PROGRAM COORDINATOR

Luisa Lambert: lulamber@montefiore.org

Phone: (718) 920 6378