End of Life Care (LaPOST)

To improve care transitions, hospitals and providers often identify patients that are considered high risk.  This risk can be identified by obvious factors such as the diagnosis and co-morbidities, assistance needed with ADL’s/IADL’s/medications, cognitive impairment, etc.  Other situations that represent high risk are frequent visits to the emergency department, frequent hospital admissions, poor prognoses or prolonged hospital stays.  When a patient has frequent visits and a poor prognosis, it becomes imperative for the health care provider to address the patient's end of life wishes.  

A palliative care consult can help clarify a patient’s goals,  facilitate discussions about advance directives, and guide care transitions so patients can receive the right level of care at the right time.  Palliative care can be administered in the hospital for symptom management, or the patient may be referred to hospice.  Several studies have shown hospices and their palliative medicine specialists, to be effective at reducing use of hospitals for their patients. In fact, families cite avoiding transitions among multiple settings as one of the benefits of hospice.

Beginning conversations with a patient or family member about end of life wishes is a topic that tends to be avoided for as long as possible, which is not usually beneficial for the patient and their family. 

The Louisiana Physician Order for Scope of Treatment (LaPOST) is a Health Care Quality Forum initiative, approved by the Louisiana Legislature during the 2010 legislative session as ACT 954, that offers tools and resources to help improve communication between health care professionals and their patients.  The LaPOST document and model of care were created to assist in effectively communicating the wishes of seriously ill patients concerning medical treatment,  as they move from one care setting to another (e.g., hospital to home/nursing home/assisted living/home health/hospice and vice versa).  For more resources and information about LaPOST, please visit www.la-post.org.          

 

Community Coalitions

Care Transitions
Learning & Action Network

LHA/eQHealth
Reducing Readmissions Training Sessions - Monthly Call Calendar

Community-Based Care Transitions Program (CCTP)

End of Life Care (LaPOST)

Tools & Resources

2011 Louisiana Quality Summit & Awards Wrap-up
PLUS Award Winners