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Palliative Care at the Doorstep: A Community-Based Model

Jackson, Molly J. DNP, AGNP-C, ACHPN; Mecklenburg, Janice MSN, ANP-BC, ACHPN; Feshzion, Abraham PharmD, MPH

Journal of Hospice & Palliative Nursing: June 2017 - Volume 19 - Issue 3 - p 282–286
doi: 10.1097/NJH.0000000000000344
Feature Articles

Palliative care is a growing specialty striving to improve quality of life in patients and families facing advanced illness, with demonstrated benefits. Outcomes regarding patients receiving community-based palliative care have not been extensively studied, with most focusing on patients with advanced cancer diagnoses. This article describes a community-based palliative care program, developed to provide care to patients with advanced illness. The mission, model of care, and program evolution are outlined; patient demographics, care settings, and comorbid diseases are reported. The average and median lengths of stay for patients who eventually transitioned to hospice care from 2012 to 2015 are compared with the affiliated hospice’s total population and with national averages. Patients receiving community-based palliative care for a diagnosis of advanced illnesses who later transitioned to hospice had an increased median and total length of hospice stay as compared with other hospice referral sources and with national averages. For patients with advanced illnesses of many types, palliative care provided in the community setting may lead to earlier identification and referral to hospice as opposed to patients not receiving palliative care, with greater support at end of life.

Molly J. Jackson, DNP, AGNP-C, ACHPN, is palliative care nurse practitioner, Western Reserve Navigator Program; and nursing faculty, Case Western Reserve University, Cleveland, Ohio.

Janice Mecklenburg, MSN, ANP-BC, ACHPN, is palliative care nurse practitioner, Western Reserve Navigator Program, Cleveland, Ohio.

Abraham Feshzion, PharmD, MPH, is medical student, Case Western Reserve University, Cleveland, Ohio.

Address correspondence to Molly J. Jackson, DNP, AGNP-C, ACHPN, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106 (

No funding was received for this submission.

The authors have no conflicts of interest to disclose.

© 2017 by The Hospice and Palliative Nurses Association.