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Creating a Fabric for Palliative Care in Safety Net Hospitals: End-of-Life Nursing Education Consortium for Public Hospitals

Virani, Rose MHA, RNC, OCN, FPCN; Malloy, Pamela MN, RN, OCN; Dahlin, Connie MSN, ANP-BC, ACHPN, FPCN, FAAN; Coyne, Patrick MSN, ACHPN, ACNS-BC, FAAN, FPCN

Journal of Hospice & Palliative Nursing: July 2014 - Volume 16 - Issue 5 - p 312–319
doi: 10.1097/NJH.0000000000000074
Feature Articles

As the numbers of medically uninsured rise, more and more Americans are depending on public/safety net (P/SN) hospitals—hospitals responsible for the care of the uninsured and underinsured. The Center to Advance Palliative Care has found that far fewer P/SN hospitals report palliative care services, compared with similarly sized not-for-profit hospitals. While the development of dedicated palliative care services is an important way to enhance palliative care in P/SN hospitals, P/SN providers may need to develop alternative strategies in these underresourced settings. The purpose of this article was to describe the implementation and evaluation of the End-of-Life Nursing Education Consortium for Public Hospitals (ELNEC-PH), a comprehensive, statewide initiative to enhance palliative care education and leadership in 16 (out of 17) California P/SN hospitals. Funded by a grant from the California HealthCare Foundation, the 2-year (2011-2013) ELNEC-PH nursing project was designed to provide education and mentoring to public hospital nurses and to promote collaboration between participants and their hospital-based palliative care programs. The ELNEC-PH project consisted of 5 main activities: ELNEC education, mentoring, online palliative care education, an annual grantee meeting, and a workshop. At 18 months after course, participants reported that the program significantly increased their effectiveness and ability to teach palliative care content to their colleagues (P = .028). There was a significant increase in the number of educational programs for all modules offered across all 16 hospitals (P < .05). Lessons learned included developing a team, aligning the palliative care program with the goals and mission of the organization, and identifying key stakeholders and their needs. The ELNEC-PH project has been an invaluable educational effort that has attempted to address the growing need for palliative care education in California P/SN hospitals, which can be a model for other P/SN hospitals nationally.

Rose Virani, MHA, RNC, OCN, FPCN, is senior research specialist/ELNEC project director, Department of Nursing Research and Education, City of Hope, Duarte, California.

Pamela Malloy, MN, RN, OCN, is ELNEC project director, American Association of Colleges of Nursing, Washington, DC.

Connie Dahlin, MSN, ANP-BC, ACHPN, FPCN, FAAN, is director of Professional Practice, Hospice and Palliative Nurses Association, Pittsburgh, Pennsylvania.

Patrick Coyne, MSN, ACHPN, ACNS-BC, FAAN, FPCN, is clinical director, Thomas Palliative Care Program, Massey Cancer Center, Medical Colleges of Virginia, Richmond, Virginia.

Address correspondence to Rose Virani, MHA, RNC, OCN, FPCN, Department of Nursing Research and Education, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010 (

This project was funded through grants by the California HealthCare Foundation (Sacramento, California) and the Archstone Foundation (Long Beach, California).

The authors have no conflicts of interest to disclose.

© 2014 by The Hospice and Palliative Nurses Association.