Icahn School of Medicine at Mount Sanai
TIER-PALLIATIVE CARE: A population-based care delivery model to match evolving patient needs to palliative care services for community-based patients with heart failure or cancer
Due to a limited specialty-trained palliative care workforce, patients often cannot access palliative care’s benefits, particularly in the community. Cancer and HF, the two leading causes of death in the US, are prototypical examples of the most common illness trajectories. The dynamic nature of these trajectories present distinct symptom patterns and changes in functional status that can create challenges with regard to the optimal palliative care delivery. To improve the quality of care for these populations, new models are needed to deliver community-based palliative care tailored to patient’s illness trajectory and changing needs. TIER-PALLIATIVE CARE (TIER-PC) is an innovative and adaptive model of delivering palliative care that provides the right level of care to the right patients at the right time. TIER-PC increases the number and intensity of disciplines added to the patient’s care team as their symptoms worsen and function declines. We will adapt and refine TIER-PC, test feasibility in a pilot RCT and then disseminate TIER-PC to improve access to palliative care for community-based patients with serious illness and match demand to the limited workforce.