VA Awards Contract to Palliative Care Project

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VA Awards Contract to Palliative Care Project

The Veterans Administration awarded a one-year contract to the Education in Palliative and End-of-Life Care (EPEC) Project based at Northwestern University to develop a program to help meet the palliative care needs of veterans and their families and caregivers.

Explains Linda L. Emanuel, MD, PhD, Buehler Professor of Geriatric Medicine at the Feinberg School and principal investigator on the contract, “The VA has a long-standing effort to build comprehensive palliative care services at every Veterans Integrated Service Network [VISN] across the country. We’re in the privileged position of providing our VA colleagues with the opportunity, venue, and resources to adapt our curriculum for their use.” Dr. Emanuel was the founding director of the EPEC Project and is the director of the Buehler Center on Aging, Health, and Society at Northwestern.

The current director of EPEC and co-investigator on the VA contract, Joshua M. Hauser, MD, says the new collaboration arose from discussions at EPEC conferences held at VA facilities over the past three years. Dr. Hauser, assistant professor of medicine, and Michael Preodor, MD, associate director of the EPEC Project and adjunct instructor in medicine, talked with Scott Shreve, DO, national director of hospice and palliative care for the VA. Subsequently, F. Amos Bailey, MD, director of palliative care at the Birmingham (Alabama) VA Medical Center, joined as chair of the EPEC for Veterans Workgroup.

“Scott wanted to do more in palliative care at the VA and do it in a more systematic fashion,” says Dr. Hauser. “This was consistent with other adaptations of EPEC, which is about teaching the principles of palliative care. This gives us an opportunity to apply our curriculum in an integrated health care system.” Most veterans receive care from VA physicians, at VA hospitals, and in VA-affiliated hospices and long-term care facilities, all linked through electronic medical records.

“Palliative and end-of-life care are clearly impacted by the military experience,” says Dr. Emanuel. “Veterans who have seen combat have a unique set of associations when it comes to symptom management and the last stages of life. Post-traumatic stress disorder and the social circumstances confronting veterans as they return from war have to be considered.”

Dr. Hauser lists four goals for this first year of formal collaboration with the VA. The first is to adapt the curriculum to specific needs of veterans and their families. The second is to develop and implement new curricular modules that arise from that adaptation. A third goal is translating the curriculum into Spanish for the first time. The fourth and final goal is to hold a training conference for groups of caregivers from every VISN. Such VA teams may include physicians, nurses, social workers, and other health care providers.

“Our hope for the future is to see how many people our initial trainers train and measure the impact of this training on the behaviors of caregivers and the experiences of palliative care for veterans and their families,” says Dr. Hauser. “The VA has some of the infrastructure that will allow us to capture those outcomes and improve the EPEC curriculum for veterans as well as for the general population.”

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