Championing palliative care.
Name: Wendy Anderson
Title: UCSF assistant professor of medicine, clinician-investigator with the Division of Hospital Medicine and Palliative Care Program
Education: M.D., UC San Diego; M.S., University of Pittsburgh
Project: Nurse-initiated multidisciplinary patient- and family-centered communications in the ICU
Innovation Profile is a monthly feature highlighting the work of a UC Center for Health Quality and Innovation fellow or grantee.
By Alec Rosenberg
When patients find out they have a serious illness, it’s a stressful time for them and their families.
For Wendy Anderson, it’s also an inspiring time, an opportunity to build relationships with patients and their families and provide support. The UC San Francisco assistant professor of medicine is making a difference by expanding palliative care – specialized care for seriously ill patients focused on quality of life for patients and their families.
“Patients and their families have a huge need for good communication with their providers at this time,” Anderson said. “There are a lot of questions. You’re very worried about what’s happening. By giving clear information and emotional support, providers can help decrease stress.”
Anderson saw firsthand the importance of emotional support when she helped care for her grandfather while he received home hospice. “We accomplished what he wanted,” Anderson said. “That showed me the power of communication.” As a resident in the intensive care unit at Duke University Medical Center, she gained more perspective on issues involving care for patients with serious illness. “I saw the power of achieving patient and family goals as opposed to our goals as providers,” she said.
Palliative care is effective for any age or stage of serious illness, from cancer to kidney failure. Research shows it improves quality of life for families and helps ensure patients get the type of care they want.
“Do they want to be looking out their bedroom window?” Anderson said. “Do they want to try an experimental therapy, even if it has high risks?”
Each of the five UC medical centers has a palliative care team. UCSF also has trained more than 180 teams of doctors, nurses, chaplains and social workers nationally to care for seriously ill patients and their families. But access to palliative care often is limited, particularly in the ICU, where terminal stays account for significant costs to the health care system.
Anderson received a UC Center for Health Quality and Innovation fellowship to address that issue. Her project to train bedside nurses to provide palliative care in the ICU is expected to expand palliative care, increase training of palliative care providers, improve quality of care and decrease costs.
“Nurses really are patients’ closest bedside provider,” Anderson said. “If you don’t include nurses in quality improvement efforts, they won’t work very well.”
Palliative care can create an 8:1 return on investment – lowering costs to payers – by reducing unwanted care and decreasing length of stay in the ICU, all while increasing patient and family satisfaction. Anderson’s project aims to decrease length of stay in UCSF’s ICU by one to three days, which could reduce yearly expenses by more than $1 million. Also, she will analyze results of patients who receive Medicare coverage, helping to make the findings transferable to other hospitals.
“At UCSF, we have more than a decade of experience of understanding the impact of palliative care on patients, families, providers and payers,” Anderson said. “By building on that, using UCSF as a laboratory, that will demonstrate its benefits and teach us how it will be implemented at other institutions.”
View Wendy Anderson’s talk at the UC Center for Health Quality and Innovation colloquium (begins at 30 minutes)