In 2005, Dr. Robert Sawicki and his staff at OSF HealthCare, based in Peoria, Ill., decided they needed to do a better job of caring for terminally ill patients. This was nearly 10 years before the Institute of Medicine's Dying in America report detailed how patients needlessly suffer in their final days, months and years.
But as leaders at the Catholic-based system explored the issue, they discovered palliative care went far beyond helping patients who were close to death. “We very quickly realized you cannot do good end-of-life care if you wait until the end of life,” said Sawicki, OSF's senior vice president of supportive care who practices family medicine. “You have to start it way upstream.”
OSF launched a palliative-care program that year, and has since made it an integral part of its accountable care organization structure. The program started at a time when palliative care was in its relative infancy as a medical specialty and was often mistakenly equated with hospice care. As experts in the field like to say, all hospice is palliative, but not all palliative is hospice.
Palliative care is based on the needs and desires of patients, not their prognosis. Doctors, nurses, social workers and other caregivers work together to offer medicine and therapies to relieve pain and improve patients' quality of life. The process is just as appropriate for Alzheimer's disease patients with a decade to live as it is for cancer patients with only weeks to live.
When OSF began its Medicare Pioneer ACO in 2012, which it still operates, Sawicki said palliative care immediately became a bigger priority. ACOs are designed to improve healthcare quality while lowering costs. Studies have shown palliative care increases patient satisfaction, reduces adverse symptoms and has the potential to save money.