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University of Pittsburgh Establishes Institute to Enhance Palliative Care

PITTSBURGH, June 5, 2003 The University of Pittsburgh, in collaboration with Family Hospice and Palliative Care, has established The Institute to Enhance Palliative Care, a community of scholars and health professionals from diverse fields who have joined together to improve care for the seriously ill and dying.

The terms palliative care and hospice describe an approach to the care of individuals who are likely to die in the relatively near future from serious, incurable disease, and for whom the principal focus of care is comfort, quality of life and support for the patient, as well as support for the patients family throughout the illness and later during the bereavement.

The institutes goal is to improve end-of-life care by expanding the number and quality of providers of palliative care and to raise awareness among patients and families of the availability of palliative care.

The Institute to Enhance Palliative Care is a response to well-documented shortcomings in the health care system, in which large numbers of dying patients and their families suffer needlessly for lack of comfort, dignity, continuity of care and family support. These problems are especially persistent in the Pittsburgh region, which has the second highest proportion of elderly in the United States, along with a large number of medical institutions and one of the nations highest rates of use of hospital intensive care units for patients who are within six months of death, said David Barnard, Ph.D., institute director, professor of medicine and director of palliative care education at the University of Pittsburgh Center for Bioethics and Health Law.

According to statistics published by the Institute of Medicine (IOM), 75 percent of patients currently die in institutions, yet a Gallup poll indicates that 85 percent of Americans would prefer to die at home. The IOM also reports that more than 40 percent of patients dying of cancer experience moderate to severe levels of pain in the last month of life. Palliative care seeks to help patients like these remain in their homes if that is their desire and to receive adequate pain medications.

The institute is particularly welcome at this time because it is increasingly apparent that patients near the end of life will benefit from palliative and hospice care to a much greater extent than from traditional, costly and often invasive hospital care. The institutes challenge is to determine how to offer this highly desirable form of care in the most productive way and to the largest number of patients with this need, said Arthur S. Levine, M.D., senior vice chancellor for the health sciences and dean, School of Medicine, University of Pittsburgh.

The institute will be housed in the School of Medicines section of palliative care and medical ethics, where since 2000 a team of nationally and internationally recognized palliative care professionals have been conducting research, training health care providers and caring for patients through several hospitals within the University of Pittsburgh Medical Center.

In this unique collaboration between an academic health care institution and a community-based hospice and palliative care program, we will have the resources to conduct focused, community-centered research and training and to provide service and advocacy based on patients most significant needs at the end stage of their illness, Dr. Barnard said.

Family Hospice and Palliative Care has been providing care and comfort to patients and their families with life-limiting illness since 1980. One of the first hospice programs in Pennsylvania, Family Hospice and Palliative Care now serves patients in 11 western Pennsylvania counties and two Ohio counties.

The institute will allow Pittsburgh to be counted among the countrys major educational centers that are the focal points for education and advocacy for quality end-of-life care. It also highlights the importance and benefit of collaboration and partnership between local leaders in palliative care, said Raphael Sciullo, M.A., M.S.W., M.S., president of Family Hospice and Palliative Care and institute co-director. The institute will provide both professionals and laypersons an opportunity to make well informed choices about end-of-life care.

The Institute to Enhance Palliative Care will focus on three areas:

Education and Training - By combining academic and community-based resources, the institute will be equipped to improve the training of all types of health care providers to ensure they have sufficient skills to manage the growing population of seriously ill and dying patients, whether these patients receive care at home or in a hospital. The institute will also mentor and encourage students to choose careers in palliative care. Various areas of the university will be involved, such as the Center for Bioethics and Health Law, the School of Medicine, the School of Nursing, the School of Law and the departments of behavioral medicine, oncology and social work.

Research - The research component of the institute will build upon existing health services research at the university by focusing research on palliative care with a particular focus on education techniques, communication regarding end-of-life issues, clinical trials in palliative medicine and the needs of family caregivers. Partnership with Family Hospice and Palliative Care will enable the extension of the research to a broad community-based population far more than is typical for most university-based health care researchers.

Community Service and Advocacy - The institute will work with other community groups, such as the End-of-Life Partnership of Western Pennsylvania and the End-of-Life Providers Task Force, to help build and support community initiatives in end-of-life care. It will closely monitor local, state and federal policies that affect care for seriously ill and dying persons and their families, and work with policy makers to provide accurate information to enable more informed decisions and policies at all levels.

Institute co-directors are Mr. Sciullo; Elizabeth Chaitin, M.S.W., M.A., D.C.H.E., director, department of medical ethics and palliative care, UPMC Shadyside; and Robert Arnold, M.D., Leo H. Criep Chair in Patient Care, professor of medicine, and chief of the section of palliative care and medical ethics, University of Pittsburgh School of Medicine.

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