Jay and Linda Grunin Foundation Bridges Palliative Care Program

THE PEOPLE:

Visiting Nurse Association (VNA) Health Group is New Jersey’s largest nonprofit Visiting Nurse Association and in addition provides a large scope of home-based health services in the state of Ohio.  For over 105 years, VNA Health Group helps individuals and families achieve their best level of well-being by providing home health care, hospice, palliative and community-based care as well as operating private-pay personal care services.  A full range of primary-care services are available through the VNACJ Community Health Centers.  Their unique partnership model with health systems leverages our clinical and technical resources to operate VNA of Central Jersey, Robert Wood Johnson Visiting Nurses, VNA of Englewood, Barnabas Home Health Care and Hospice, Visiting Physician Services, and Visiting Nurse Association of Ohio.  Currently, VNA employs nearly 2,500 individuals each year and care for over 150,000 individuals and families including a special focus on vulnerable populations such as children, older adults and those with serious and disabling chronic illness.

THE IDEA

Visiting Nurse Association Health Group (VNA Health Group), launched the Jay and Linda Grunin Bridges Palliative Care Program in August of 2018, in partnership with RWJBarnabas Health’s Community Medical Center, Monmouth Medical Center Southern Campus and Monmouth Medical Center. This program is in response to many obstacles New Jersey residents face when accessing end-of-life care. There is a lack of straightforward conversations between medical professionals and patients and their families, as well as patient and family misconceptions about palliative or hospice care. Although most residents wish to spend their final days at home, studies show that only a small percentage of those in NJ actually die at home. The Jay and Linda Grunin Foundation committed funding to the program, knowing how confusing and painful the typical course of care can be for patients at the end of their life journey.

THE IMPACT

The Jay and Linda Grunin Bridges Palliative Care Program will provide approximately 600 palliative medicine consultations to offer better care for home health patients who may be eligible for palliative or hospice services. The goal is to produce better outcomes for patients and families at a lower cost to the healthcare system overall. Through this program, VNA Health Group hopes patients and families will be better informed of their choices, have a better quality of life, and have extra time with their loved ones.

THE UPDATE

We are already seeing significant development since the inception of the Jay and Linda Grunin Bridges Palliative Care Program on August 1, 2018:

  • Vandana Sharma, MD, HMDC joined the VNA Health Group team to provide palliative medicine consults in the community in collaboration with Marianne Holler, DO, FACOI, CMO, VNA Health Group and Vicki Sharma, MD.
  • Training and education programs to clinical staff on a community based model are in progress.
  • Public education tools to raise awareness of availability of palliative medicine consults are being developed and expanded.
  • Over 100 Goals of Care Conversations have been performed by physicians, social workers, and nurses assuring patients and families are aware of all available options for care.
  • 10 new community palliative consults have been performed.

A case example: A gentleman in his 70s was referred with end stage liver disease due to a decline in his medical status and ability to function over the past few months. He had multiple medical admissions for repeated paracenteses to drain accumulating fluid.   During the palliative consult visit, he completed his living will outlining his wishes for no aggressive interventions. The discussion and eventual placement of a tube for drainage to eliminate frequent re-hospitalizations occurred.  He began to explore his feelings regarding hospice and scheduled a follow-up visit in one month.

The program expects to grow consistently over the next quarter, performing 50 consults per month by year-end 2018. For more information, please visit VNA Health Group.