Subspecialty Consults and Clinics Expectations
Palliative Care Outpatient - Goals and Objectives
- Develop an understanding of diseases and symptoms seen by palliative care physicians in the outpatient setting
- PGY-1: Learn the initial assessment of symptoms and diseases that are commonly referred for palliative care in the outpatient setting
- PGY-2: Develop an advanced understanding of complex presentations of symptoms common to patients needing palliative care in the outpatient setting
- PGY-3: Develop advanced processes to recognize and treat complications and complex symptoms in outpatients receiving palliative care
- Competency: Patient care, Medical knowledge
- Learn pharmacological management of symptoms for outpatients needing palliative care
- PGY-1: Develop a basic differential diagnosis for common clinical scenarios in outpatients with severe illnesses approaching the end of life
- PGY-2: Develop an expanded differential diagnosis for common clinical scenarios in outpatients with severe illness receiving palliative care
- PGY-3: Recognize unusual presentations of clinical situations in outpatients with severe illness receiving palliative care
- Competency: Medical knowledge
- Utilize the EHR and patient dashboards to engage in population management
- PGY-1: Learn how to use the electronic health record (EHR) to help manage patients receiving palliative care
- PGY-2: Identify noncompliance or patients who are outliers using the EHR and dashboards.
- PGY-3: Develop advanced care plans with the interdisciplinary care team to manage
- Competency: Systems-based practice, Practice based learning and improvement
- Understand the unique outpatient needs of palliative patients
- PGY-1: Recognize the unique outpatient needs of palliative care patients
- PGY-2: Understand the community resources available to palliative care patients
- PGY-3: Learn how to work with an interdisciplinary care team to optimize the availability and utilization of community resources available to palliative care patients
- Competency: Patient care, Systems-based practice
Palliative Care Inpatient Consults - Goals and Objectives
- Develop an understanding of diseases and symptoms seen by palliative care physicians in the hospital
- PGY-1: Understand the basic principles of assessing and managing symptoms and diseases in hospitalized patients needing palliative care
- PGY-2: Learn how to manage complex presentations of symptoms common to hospitalized patients needing palliative care
- PGY-3: Develop advanced processes to recognize and treat complications and complex symptoms in hospitalized patients with multiple medical problems receiving palliative care
- Competency: Patient care, Medical knowledge
- Understand the differential diagnosis of clinical scenarios that can be seen in hospitalized patients receiving palliative care
- PGY-1: Develop a basic differential diagnosis for common clinical scenarios in hospitalized patients with severe illnesses approaching the end of life
- PGY-2: Develop an expanded differential diagnosis for common clinical scenarios in patients with severe illness receiving palliative care
- PGY-3: Recognize unusual presentations of clinical situations in patients with severe illness receiving palliative care
- Competency: Medical knowledge
- Learn pharmacological management of symptoms for hospitalized patients needing palliative care
- PGY-1: Learn the common medications utilized for the management of symptoms that can occur in patients needing palliative care
- PGY-2: Understand how to manage complicated clinical problems and develop specific therapeutic strategies in patients with symptoms needing palliative care
- PGY-3: Learn how to develop personalized care plans for hospitalized patients and intersecting clinical problems needing palliative care.
- Competency: Medical knowledge
- Effectively consult on inpatients, develop, and execute assessment and management plans
- PGY-1: Learn the steps required to be an effective palliative care consultant. Recognize how to prioritize patient problems.
- PGY-2: Develop management plans for palliative care of admitted patients
- PGY-3: Understand interactions between patient symptoms, underlying health issues, and patient preferences and develop advanced strategies to prioritize management
- Competency: Patient care
- Effectively execute day-to-day management of patients
- PGY-1: Learn to manage palliative care patients on a daily basis including a daily assessment and determining progress symptom management
- PGY-2: Understand how to adjust palliative care patient treatment plans based on symptom improvement or progression and determine the need for additional assistance such as subspecialty consultation
- PGY-3: Recognize how to manage complex symptom presentations and manage both expected and unexpected complications.
- Competency: Patient care
- Interdisciplinary care and discharge planning
- PGY-1: Learn how to communicate effectively with the interdisciplinary care team and anticipate patient needs for discharge and effective follow-up
- PGY-2: Recognize the unique needs of palliative care patients and help integrate patient needs with available resources
- PGY-3: Learn how to manage advanced situations such as end-of-life decisions, complex transitions of care, and advocate for patients and families when resources are limited
- Competency: Patient care, System-based practice
- Familiarity with the electronic health record and optimization of its use
- PGY-1: Develop a basic understanding of The EHR and its core components and how it can be used to care for patients needing palliative care
- PGY-2: Understand and teach others on how to effectively use the electronic health record in the care of patients receiving palliative care
- PGY-3: Develop an understanding of advanced medical informatics in the care of patients receiving palliative care by utilizing additional resources in the EHR
- Competency: Systems-based practice
- Communication and teamwork
- PGY-1: Recognize the core members of the patient care team involved in care of patients receiving palliative care, to include nurses, patient technicians, physical therapists, occupational therapists, case managers, chaplains, social workers, and hospital administration personnel.
- PGY-2: Develop effective and timely communication strategies with the interdisciplinary care team for patients needing palliative care.
- PGY-3: Use advanced communication methods to engage and coordinate care with the interdisciplinary care team for patients receiving palliative care.
- Competency: Professionalism, Interpersonal and communication skills
Starting in the academic year 2023-24, the palliative care hybrid will be a combination of both consults and outpatient experiences as indicated on QGenda. Toggle through tabs for information for the pertinent assignments.
Parkland Consults
Contact: Padmaja Reddy (214-717-0225)
Location: NPH 14-600 (far side), occasionally one resident will be assigned to CUH. Details about this experience will be communicated to you before the start of the rotation.
Hours: 8:30am-5pm (family meetings occasionally run later), Mondays, Tuesdays, Thursday PM and Fridays.
Number of residents: 1-2 residents on service at any given time
Team composition: Residents will mainly be paired with one consult attending but will also interact with the other members of the Palliative Care team.
- Inpatient: 3-4 attending physicians, 2-3 nurse practioners, 1 social worker, 1 fellow, 1 resident, 1 medical student
- Outpatient: 3-4 attending physicians, 1 social worker, 1 chaplain, 1 nutritionist, 1 pharmacist, variable number of learners
Parkland Palliative Care Clinic
PMH Palliative Care Clinic (P Palliative)
Contact: Eileen McMenemy
Phone: 214-590-5585
Location: Moody Building, Suite 3B
Time: Mondays 8am-12pm, Tuesdays 1pm-5pm, Wednesdays 8am-12pm & 1pm-5pm, Thursdays 8am-12pm, Fridays 9am-12pm
- Wednesdays are when residents on Palliative Care Hybrid will be in attendance.
Logistics:
- When you arrive in clinic, you’ll be paired with a faculty member.
- Expect to see at least two patients per half day. Notes should be submitted prior to leaving clinic.
- Templates for notes and discharge instructions are available in Epic as SmartTexts.
- All discussions regarding prognosis, advance care planning, goals of care, and/or Hospice should take place with an attending present.
CUH Consults
Contact: Carla Khalaf McStay ()
Hours: 8:30 AM - 5 PM, Monday - Friday
Location: CUH room 8.314, door code 6425#
Number of residents: 0-1 residents on service at any given time
Team composition: Two consult teams (C1 and C2), resident will be paired with one attending with interaction with other interdisciplinary team members. There are sometimes fellows or medical students on the team with opportunities for bedside teaching.