The Grady Cancer Center for Excellence has received a $200,000 grant from the Lance Armstrong Foundation to establish a palliative care clinic for cancer patients at Grady Memorial Hospital. The clinic, which is scheduled to open on January 19, 2006, is the first of its kind at Grady Hospital.
Tammie Quest, MD, assistant professor in the Department of Emergency Medicine at the Emory University School of Medicine, is the medical director of the clinic.
Dr. Quest says the new palliative care service will deliver well-managed, high-quality care to at least 200 cancer patients requiring long-term management of complex and multiple problems. The clinic will initially be open to patients from Grady's Cancer Center one afternoon each week, and it will eventually receive referrals from other clinics in the hospital. Any cancer patient with uncontrolled symptoms or other palliative care issues will be seen at the new clinic, and special emphasis will be given to stage four cancer patients who often present with a higher symptom burden.
All patients will receive comprehensive symptom, psycho-social, and spiritual assessments. Advanced care planning, caregiver issues, and faith-based decision-making are primary issues that will be addressed.
"Our focus is to have an interdisciplinary, culturally-sensitive clinic that actually takes into account issues of spirituality and faith-based decision making," Dr. Quest explains. "Our hope is that this program will be an initiation of one model of palliative care at Grady with the idea that it will extend into a hospital-based service that will include more than just cancer patients."
Dr. Quest is the only physician at Grady Memorial Hospital board certified in Hospice and Palliative Medicine, and she is among a handful of full-time emergency medicine physicians in the country with the certification. There are more than 1,900 physicians certified by the American Board of Hospice and Palliative Medicine.
Palliative medicine is the study and treatment of patients living with life-threatening or severe advanced illness who are expected to progress toward dying, and where care is particularly focused on alleviating suffering and promoting quality of life. This medical discipline helps the patient and family face the prospect of death assured that comfort will be a priority, values and decisions will be respected, spiritual and psychological needs will be addressed, practical support will be available, and opportunities will exist for growth and development.
Dr. Quest says that clinic staff, which will include a nurse, chaplain, and social worker, will be trained in palliative care with a special emphasis on working with African-American patient populations.
No one in the clinic will be excluded from palliative care services, even if they are undergoing radiation or chemotherapy, Dr. Quest notes. Instead, medical staff will use an integrative model and actively collaborate with the patient's primary oncologist to optimize treatment.
Grady's palliative care clinic is modeled after a similar program at Parkland Memorial Hospital in Dallas, Texas.
"Because patients in indigent care populations have lots of complex needs, the idea is to have intense case management focusing on those issues," Dr. Quest says. "Our primary outcomes are going to be decreased hospitalization, decreased emergency department visits, decreased pharmacy costs, and increased quality of life for those patients."
The Lance Armstrong Foundation was founded in 1997 by champion cyclist and cancer survivor Lance Armstrong. The foundation's mission is to provide practical information and tools for people living with cancer through education, advocacy, public health, and research programs.