Achieving Excellence in Palliative Care Series

Medical treatment in the last chapter of life is characterized by three major deficits: 

  • Poorly treated pain with up to 50% of patients experiencing poor pain control in the last days and weeks of life 
  • High treatment variability with some patients receiving 3 —6 x as much intensive treatment as others without being sicker or having a better outcome. Those patients receiving this excess treatment are in essence receiving ineffective treatment. There is even some data to support the notion that outcomes are worse in parts of the country with the highest utilization of health care resources in the last 6 months of life. 
  • High costs for this painful and ineffective treatment with approximately of all health care dollars spent in the last year of life. 

Physicians and nurses are directly responsible for trying to improve all three areas of deficit will benefit from participation in this internet enduring series.

Target Audience

All physicians, nurses, social workers, chaplains and other palliative care professionals who treat patients who might die under their care.

Learning Objectives

  • Identify current gaps and deficits in EOL care. 
  • Identify models for end of life care. See and accept our own mortality. 
  • Identify five domains to be improved in EOL care. 
  • Recognize specific markers for terminal, end stage illness. 
  • Recognize barriers to effective communications. 
  • Use a five-phase strategy of conversations to communicate "bad news" in the setting of critical illness. 
  • Identify specific problems with communication in the setting of brain injuries. 
  • Identify the concept of total pain. 
  • Use the WILDA method of pain assessment .
  • Use the WHO Pain ladder.
  • Understand basic opioid pharmacology.
  • Understand the principles of opioids in pain management.
  • Describe the demographics of aging and end of life care. Understand the financial challenges of end of life care. Have the knowledge base and skill set to gently lead discussions as appropriate about utilization of scarce resources. 
  • Recognize the interpersonal, spiritual, and cultural factors in EOL care and be able to work with an interdisciplinary team on those factors in a way that will enhance patient care. 
  • Explain Texas specific definitions of terminal and irreversible illness. Lead an advance care planning discussion. Be able to use and interpret specific documents such as the Directive to Physicians and the OOH-DNR. 
Course summary
Course opens: 
Course expires: 

Dr. Fine does not have any relevant financial relationships.

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education to physicians.

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Required Hardware/software

This activity works best in Google Chrome.