U-M Health System’s new adult palliative medicine program to enhance research, patient care

Adam Marks, M.D., co-director of the Palliative and Supportive Care Clinic at the East Ann Arbor Health and Geriatrics Center, speaks with patient Marilyn Blanch and husband E.J.

For some patients living with an advanced disease, the main goal of treatment isn’t to be “cured” – it’s to maintain a comfortable and satisfying life.

The U-M Health System is furthering its commitment to care that enhances quality of life with the start of a new academic program that will expand clinical care, education and research opportunities related to adults with chronic debilitating disease.

UMHS’s new Adult Palliative Medicine Program poises the institution as a national leader in the emerging field of palliative care – an area of medicine focused on relieving and preventing pain for patients at any stage of an illness. This includes the management of both physical and emotional disease symptoms for patients undergoing treatment for curable illnesses, those living with chronic diseases and those nearing the end of life.

“Some people mistakenly believe that palliative care is only for patients who are incurably ill,” says Raymond Yung, M.D. chief of the Division of Geriatric and Palliative Medicine in the U-M Medical School. “The goal of palliative care is to provide relief from symptoms, and stress of a serious illness- whatever the diagnosis”.

“The new APM Program at the U-M Health System is a pivotal step in our commitment to support these patients through their disease, whether they need new pain remedies, help making difficult medical decisions or emotional guidance. The new program brings disciplines together across the system and the health science schools and will put us on track to become a national center of excellence for clinical care, academic research and education in this increasingly important and growing area of care.”

The new structure builds on over a decade of interdisciplinary work to establish high quality clinical and educational programs in palliative care. It unites palliative medicine specialists, nurses, social workers and many others from across the health system and campus, focused on addressing physical, emotional, spiritual, and social concerns that arise with advanced illness.

The program is expected to enhance UMHS’s existing Hospice and Palliative Medicine fellowship program, foster new research and philanthropic opportunities and help form new clinics focused on palliative care. UMHS offers outpatient palliative programs in the Geriatrics Center, Chelsea Family Medicine, and the Supportive Care and Symptom Management Clinic in the U-M Comprehensive Cancer Center.

“Building on the expertise that exists through the health system and the schools, our new palliative care program is devoted to helping patients with serious illness live longer and more satisfying lives,” says Margaret Calarco, Ph.D., R.N., chief of nursing services.

“This new collaborative program will serve as a major hub of palliative care experts in the Ann Arbor area. It will allow us to increase the number of clinical trials and research opportunities in palliative care, enhance symptom management of patients with chronic illnesses and reduce the burden on caregivers.”

The palliative medicine team works together to create a comprehensive plan of care for patients. Examples of palliative care may include helping a patient recover from an illness by easing symptoms such as pain, anxiety or loss of appetite during surgery, chemotherapy or other procedures. Palliative care may also help patients transition to home after being released from a hospital or nursing facility.

The UMHS palliative medicine program will include representation from the Department of Internal Medicine (and several of its divisions, such as Geriatric and Palliative Medicine, Hematology/Oncology, Nephrology, General Medicine and the Hospitalist Program), the Department of Family Medicine, the School of Nursing, the School of Social Work, Emergency Medicine and the School of Pharmacy.

An oversight steering committee with representation from multiple departments has been created to coordinate all APM Program activities, and to ensure a push towards growth and excellence. A national search is being conducted to recruit a program director and associate directors for each of the three spheres of the program: research, clinical care, and education.

“We are eager to invest in what we believe is the first-of-its-kind palliative medicine program that requires the collaboration of Family Medicine and Internal Medicine, along with the expertise of other departments and the hospital,” says Philip Zazove, M.D. chair of the U-M Medical School’s Department of Family Medicine and chair of the palliative care program’s steering committee.

“This unique structure allows us to tap into our top palliative care resources at the Health System to most efficiently provide leading educational opportunities and cutting-edge research, in addition to our stellar clinical care, in this critical area of healthcare.”

The Division of Geriatric and Palliative Medicine, which currently oversees the Hospice and Palliative Medicine Fellowship and has 17 faculty members already board-certified in palliative care, will provide the academic and administrative oversight for the program.

UMHS’s adult inpatient consultation service has cared for 4000 patients and their families since 2006, providing educational opportunities to learners from medicine, social work, nursing and pharmacy.

“The goal is to provide the most advanced care to our patients through the creation of the premier academic program in the nation for palliative medicine,” says John Carethers, M.D., chairman of internal medicine and a member of the multidisciplinary working committee that developed the organizational framework for the initiative.

Members of the working committee are Margaret Calarco (Nursing), Philip Rodgers (Family Medicine), Philip Zazove (Family Medicine), Kenneth Bandy (Palliative Care), John Carethers (Internal Medicine), Raymond Yung (Division of Geriatric and Palliative Medicine), Rick Bluhm, (Division of Geriatric and Palliative Medicine), and Robin Damschroder (Hospital Operations and Clinical Services).

Members of the Steering Committee are: David Smith (Hematology/Oncology), Scott Flanders (Hospitalist Program) Caroline Vitale (Division of Geriatric and Palliative Medicine), Sanjay Saint (General Medicine), Ray Yung (Division of Geriatric and Palliative Medicine), Dan Clauw (Anesthesiology), Phil Rodgers (Family Medicine), Rusty Chavey (Family Medicine), Phil Zazove (Family Medicine), John Carethers (Internal Medicine), Janet Larson (Nursing), Kathy Wade (Social Work), Jim Hayman (Radiation Oncology), Hae Mi Choe (Pharmacy), Robin Damschroder (Hospital), Marge Calarco (Nursing), Rick Bluhm (Division of Geriatric and Palliative Medicine), Andrew R. Barnosky (Emergency Medicine).

Please see our press release here: http://umhealth.me/palliativemed

For more information on palliative care at UMHS, visit: http://www.uofmhealth.org/medical-services/palliative-and-supportive-care

See the quote board on what faculty members, leaders and community members have to say about palliative care at UMHS: http://www.uofmhealth.org/palliative-medicine-quote-board

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