Palliative Care IC

Palliative Care Individualized Curriculum

Rotation Director:

Name: Bob Macauley

Email: macauler@ohsu.edu

Bridges Contact Information

Bridges Pager: #17244

Bridges Phone: 503-494-6201 (if you leave a voicemail, a page will be sent to the Bridges pager)

Bridges Group:

Bob Macauley, Physician and Bridges Medical Director

Anat LeBlanc, Chaplain

Kathy Perko, Nurse Practitioner and Bridges Program Director

Lindsay Wooster, Social Worker

Melanie Madigan, Administrative Coordinator

Monica Holland, Nurse Coordinator

Sara Taub, Physician

Tyler Tate, Physician

Overview:

This rotation fulfills an individualized curriculum requirement for the ACGME. This rotation aims to expand on the knowledge and experience gained during the intern year rotation, in particular for those with a particular interest in palliative care, or who anticipate collaborating frequently with this specialty in their future post-residency.

General objectives:

1. Daily table rounds on patients with multidisciplinary team

2. Consults in NICU, PICU, PHO, and wards

3. Involvement in MFM/NICU conferences

4. One on one teaching sessions with attendings on topics such as management of opioids, difficult conversations, etc.

5. Introduction to chaplaincy from the spiritual care team

Prior to the start of the rotation:

You will receive an email from Melanie Madigan welcoming you to the rotation with

- Some general information about where/when to arrive on your first day

- contact information for your lead, the Bridges Group member who will shepherd you through the rotation

Resident Expectations:

-You still should be able to attend morning report and noon conference most days, if not all. Help us help you get there on time.

-Expect to be involved in rotation activities from roughly 9am to 5pm on weekdays only.

-The majority of your time will be spent with the Bridges Group, participating in daily handoff, seeing patients for new consults and follow up visits with other members of Bridges, attending pertinent care conferences and work group meetings. You also may have the opportunity to work with other groups (Child Life).

-You will be asked to complete some didactic sessions with members of the Bridges Group, as well as some self-directed learning, including required and optional readings (see didactics and reading sections below).

-You will be invited to participate in a writing exercise around one of your patient experiences.

General Schedule:

In addition to our handoff, which takes place at 9:30am every day, there are some recurring meetings that you should plan to attend with us during your rotation insofar as they do not conflicts with your continuity clinic.

Monday: NICU Discharge Planning Rounds from 11:30am to noon (Attending office in the NICU)

Tuesday: Bridges symptom Management Standardization Meeting from 3-3:30pm on select Tuesdays

Wednesday: Fetal Therapy Conference from 12:30pm to ~2pm (Doernbecher 9^th floor conference room - 09301)

Friday:

-The first Friday of every month from 8-9am: All City Palliative Care Meeting (topic and location to be announced; we will share the information with you during your rotation)

-NICU Discharge Planning Rounds from 11:30am to noon (Attending office in the NICU)

If you are going to be absent for all or part of a day:

1. Let chiefs and Mike Grubbs know

Resident Resources:, Helpful Tips, and Further Readings:

You will receive a BOX invitation that will give you access to most of the required and suggested readings for the rotation.

Required Readings include:

1. Douglas Hill et al., “Regoaling: a conceptual model of how parents of children with serious illness change medical goals,” BMC Palliative Care 2014, 13: 9-16.

2. American Academy of Pediatrics Section on Hospice and Palliative Medicine and Committee on Hospital Care, “Pediatric Palliative Care and Hospice Care Commitments, Guidelines, and Recommendations.” Pediatrics 2013; 132(5): 966-972.

3. Julia Downing et al., “Pediatric pain management in palliative care,” Pain Management 2015; 5(1): 23-35.

4. Elissa G Miller et al., “Concurrent care for the medically complex child: Lessons of implementation,” Journal of Palliative Medicine 2012; 15(11): 1281-1283.

One of the required readings is a short book that is a fast read. We will loan you a copy at the beginning of the rotation: Back, A; Arnold, R; Tulsky J (2010). Robert Arnold, James Tulsky. Mastering Communication with Seriously Ill Patients. New York, NY: Cambridge University Press.

Between all of us, we have a pretty robust library of pediatric palliative care books, so please let us know if we can assist you in identifying additional resources.

Some Additional Resources

Courageous Parent Network: https://courageousparentsnetwork.org/

“A destination created by families, for families, to support, guide and strengthen them as they care for very sick children”

Palliative Care Fast Facts And Concepts: https://www.mypcnow.org/fast-facts

Pediatric Palliative Care Fast Facts And Concepts: https://www.mypcnow.org/pedfastfacts

“Fast Facts are designed to provide concise, practical, peer-reviewed, and evidence-based summaries on key palliative care topics”

Center to Advance Palliative Care: https://www.capc.org/

“The Center to Advance Palliative Care (CAPC) provides the essential tools, training, technical assistance, and metrics to build and sustain palliative care in all health care settings”

National Hospice and Palliative Care Organization: https://www.nhpco.org/

“The largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States.”

American Academy of Hospice and Palliative Medicine: http://aahpm.org/

“AAHPM is the professional organization for physicians specializing in hospice and palliative medicine, nurses, and other healthcare providers.”