Overview: The Kansas City Hospice House is a 32-bed acute inpatient hospice facility that provides services for the patients of Kansas City Hospice and Palliative Care. The patients carry a wide range of diagnoses, including non-cancer diagnoses such as stroke, CHF, dementia, sepsis, renal failure among others. During training, the fellow gains in-depth exposure to acute pain and symptom management, management of the natural dying process, and counseling for patients and families dealing with end-of-life issues. The fellow will work closely with an interdisciplinary team of nurses, social workers, chaplains, music therapists, pharmacists, dietitians and others. The fellow will follow patients on "Acute" (GIP) and "Residential" (Routine) admission status during their rotation.
Collaboration with staff: The fellow will make daily rounds during the week, interacting with the nurses (RN, LPN), care assistants, social workers, chaplains, volunteers, music/art therapists, and dietary on an ad hoc basis as clinical needs arise. Many of these informal interactions form the basis of acute, timely clinical care. These staff will be encouraged to collaborate with the fellow as learners and as teachers. The fellow will seek appropriate members of the IDT to assist and educate in difficult situations.
Patient and family interactions: Family meetings are held as needed with the fellow, attending, social worker, patient and family in attendance. Every other week the IDT meets formally for two hours to discuss patients and families. The fellow will be present to review patients along with the rotating attending and will gain skill in the necessary documentation of the hospice medical director. The fellow will be expected to have a firm understanding of the patient's medical issues, will collaborate with the IDT to elucidate any psychosocial issues to be addressed, and will serve as leader for these meetings as the year progresses and the fellow develops skill.
Duration: The fellow will spend a total of two months in the inpatient hospice venue, spread across the year. As the fellow progresses, he or she will function more independently as the patient/family care provider, with ongoing support from the hospice attending.
Hospice IDT: The fellow will attend Tuesday morning hospice house IDT which is held every other week. In addition, the fellow will act as the medical director for a home or long-term care hospice team for Kansas City Hospice & Palliative Care on Wednesday mornings when they are on KCHPC based rotations. The IDT will be comprised of a team manager, social workers, a chaplain, nurses (RN and LPN), care partners, and medical records. This experience affords the fellow a better chance to learn more about the administrative duties of a hospice medical director. The fellow will communicate with the patient's primary attending if a major change in medical orders is indicated. The fellow will also communicate with the long-term care facility staff, including the patient's primary physician and the director of nursing as necessary to ensure excellent clinical care.