Letter to Hospital
CEO's:
Tim Thompson asked if there
were any comments on Arnold Goledetz's letter. Tim stated that he
wanted to add something about St. Johnsbury. He will add his part
and fax to the VMS for formatting and to send out.
Regional Reports:
Burlington:
FAHC is backing a project to distribute pain protocols created by
Zail Berry. They are going to be distributing these to all
physicians and students there. Tim is going to call Dr. Brumsted to
see about disseminating this material to all hospitals in the state.
The pain protocol is a pocket sized flip chart with protocols on
pain management and symptom control. Tim would also like to send out
a special mailing to the FAHC Board of Trustees to get their support
of FAHC funding the dissemination to all Vermont Hospitals.
FAHC has recently gained a new
ethicist. Bob Orr, M.D. has signed on as Ethicist for FAHC
palliative care program.
Central Vermont:
Diana Peirce reports that the CVH palliative care program has been
up and running since January with 10 patients: 8 patients went home,
2 died in the hospital very comfortably with standing orders. Diana
also said that the hospital has been excellent about using the
standing orders. The palliative care team for CVH is John Valentine,
M.D., Marylin Hart, M.D., Diana Peirce and Elaine Owen.
Diana also reported that CVH is going
to be getting a chaplain, which they are going to fund.
Tim asked Diana what some of the
start up problems were with CV palliative care program. She said
that in the beginning they were trying to be very scientific about
the whole thing, but found that they really just had to go with
their gut feelings. She also noted that they had a lot of problems
with pharmacies and standing orders, but found that most medicines
should be home based.
Dartmouth:
Tim Thompson reports that Dartmouth's palliative care program is set
to start up in the end of September or beginning of October. Their
team consists of 2 internists, 1 anesthesiologist, 1 psychiatrist
and 1 cardiothoracic surgeon. Tim feels that this is a very exciting
venture. The program has funding of $1.3 million plus sponsorship of
50% for the next 5 years. Tim thinks they need 3 or 4 good leaders
and then they can tie in with Central Vermont. Once they get going
he hopes they will do home visits and work with the hospice program.
Tim has been offered a position to
participate in this program part time. He has not decided whether he
is going to accept this opportunity, but does stress the need for
New Hampshire to start palliative care programs and hospices.
St. Johnsbury:
Tim presented to the Board of Trustees. asking them to support the
palliative care program and to finance a support person and some of
Tim's time so he could take time from his practice to concentrate on
the program.
Brattleboro & Bennington:
Tim reported that the Brattleboro palliative care steering committee
has been working very hard. The October seminar Bennington hit their
limit of 30 attendees and had to close down. Both hospitals are
ready for advanced directives help.
Web Page:
The group discussed what
information should be put on the web page. Tim is going to get Zails'
pain protocol and Don Berwick's and Joann Lynn's articles. John
Campbell will get Denise's article and will ask Arnold about his
discussion draft. Ginny will get the 10 things List. All web page
information will be e-mailed to Stephanie Lane at slane@vtmd.org.
Tim also asked John Campbell to put any applicable published
materials or the advanced directives materials on the web site and
distribute them through the list serve.
Task Forces:
Madeleine Mongan went over
the list of task forces that are currently active and members of
those task forces.
- Palliative Care in Hospitals
There are now protocols in Central Vermont, Caledonia and
Burlington.
- Mission Statements:
Arnolds letter to the hospital CEO's will be going out after Tim
adds a piece about St. Johnsbury.
St. Johnsbury needs to give the
okay. The door needs to be opened at FAHC.
Central Vermont is going great and smoothly.
- Hospice Certification:
There doesn't seem to be much interest from people to get
certified, so Tim thought that someone should to go into the
hospices to get more interest.
Currently there are only 6
certified physicians in the state and more than 40 nurses.
Physicians must be re-certified every 6 years, nurses every 4. The
nurses are moving to have in-service credits replace the test.
Physicians who are now certified
are: Tim Thompson, M.D., Judy Hills, M.D., Denise Niemira, M.D.,
John Valentine, M.D., Skip Linton, M.D., and Marilyn Hart, M.D.
- Quality:
Madeleine reported that Helen Riehle is now the new director of
VPQHC. The would be invited to the next meeting of ExCEL, along
with the Governor after the election.
- AMA EPEC Training:
Tim reports that this aspect of palliative care has been
underwhelming.
Other Business:
Diana Peirce relays to the
group that there are an average of 40 hospice patients per day and
40-60 palliative care patients per day in Central Vermont.
John Campbell asks for advice about
how to circulate the end-of-life poster created by VEN. Madeleine
suggests that the VMS bring some to their annual meeting. John asks
about primary care physicians and Stephanie Lane suggests bringing
the poster to the ACP-ASIM Combined Meeting in November. We will
wait and see if the meeting handouts work and then send a letter to
practice managers of internists and family practice physicians with
a cover letter urging them to put it up with the VEN contact
information.
Ginny needs speaker feedback from the
group. She needs to start lining someone up for next year's June
meeting. If anyone has any ideas please contact her. One idea for a
speaker is Kathleen Foley.
Next VEN Venue:
Will be in January of 2001 in Central Vermont.
Meeting Schedule:
All conference calls will use the same dial up number (800-852-7711)
and conference code (37898)
All meetings at the VMS will be held in the carriage house
conference room
Thursday October 19, 2000
Tuesday November 21, 2000
Thursday January 18, 2001
Thursday February 22, 2001
Tuesday March 27, 2001 |
7:30a.m. - 9:30a.m
2:00p.m. - 4:00p.m.
7:30a.m. - 9:30a.m.
7:30a.m. - 9:30a.m.
2:00p.m. - 4:00p.m. |
Conference Call
At VMS
Conference Call
Conference Call
At VMS |
|
