20th Anniversary of the Palliative Care Service
This Saturday, March 9, 2019 marks the 20th Anniversary of the inpatient Palliative Care Service (PCS) at Parnassus.
Dr. Steve Pantilat wrote the following to commemorate the journey:
A few years ago, during rounds a medical student asked me when the palliative care service was launched. “1999,” I said. She thought for a moment and then asked, “What did we do before palliative care?” She reminded me that the Palliative Care Service at once seems so essential and yet was not always part of our UCSF clinical services (nor available anywhere across the U.S.). This Saturday, March 9, 2019 marks the 20th Anniversary of the inpatient Palliative Care Service (PCS) at Parnassus. I wanted to mark this historic anniversary and share some of our early history.
The PCS grew out of an observation and concern that the patient and family experience at the end of life at Moffitt-Long was not what it should be. We had been jury rigging rooms to accommodate family members of people who were dying and realized that there was even more that we could do to improve the experience at the end of life, including remodeling rooms to be more home-like for people who were dying and needed to be in the hospital.
A dedicated interdisciplinary group that included Mike Rabow, Steve McPhee (professor in DGIM), Carol Mowbray (nurse manager of 12L- the old medicine unit), Jane Hirsch (Director of Nursing), Rod Seeger (Director, Spiritual Care), Tom Bookwalter (Pharmacist, medical service), Ann Alpers (lawyer and researcher in the program in medical ethics), and me began meeting in 1998 to plan a new consultation service and a two Comfort Care Suites. With great support from the hospital medicine group and DGIM, which was our academic home, and after 9 months of planning, a commitment from the medical center to convert two existing rooms on the medical floor (12L back then) to Comfort Care Suites, and with the support from the Mt Zion Health Fund to remodel those rooms to look more like home, we were ready. One day in early 1999, Carol Mowbray said we've planned enough and just need to pick a day and get started. We chose Tuesday, March 9 and the PCS pager went live that day. We received two consults that day and cared for 112 people in that first year. In year one, 80% of the people we cared for died in the hospital.
Over the past 20 years the PCS has cared for more than 10,000 people with serious illness from every service and every unit in the hospital. In 2018 alone we saw over 1000 patients, 72% of whom left the hospital. Our service has achieved this remarkable growth on the strength of the high quality, compassionate, kind, empathetic, expert palliative care that we provide to our patients and their loved ones and the help we offer to our colleagues. We now have two teams at Parnassus- Heart and Soul- and one at Mission Bay that began at Mt Zion (with support from the Mt Zion Health Fund) and moved to MB along with the other inpatient services. Our teams are comprised of social workers, chaplains, nurses and physicians who provide expert, interdisciplinary care to people with any serious, life threatening illness. We teach trainees and students from all disciplines and host visitors from around the world who want to learn how to provide the highest level of care and service.
None of this success could have been possible without the tremendous dedication of all of the remarkable clinicians who have been part of the PCS over the past 20 years and the strong and uncompromised commitment of leaders across UCSF who have nurtured and supported the idea of palliative care and the PCS. Our commitment to whole person care, interdisciplinary teamwork, and to aligning the care that people receive with their wishes serve as the unwavering foundation of our service. We are proud to be among the first palliative care services in California and the nation and to serve as a model of care for people with serious illness that has been replicated at hospitals across the country.
As the PCS grew so did the recognition that people with serious illness need palliative care everywhere. In 2005, Dr. Mike Rabow launched the Symptom Management Service at the Cancer Center. In 2013 Dr. Brook Calton started our home-based PC service, Bridges, and in 2017 Dr. Kara Bischoff established the Outpatient PCS to care for people with serious illnesses other than cancer. We are grateful for the opportunity to do this important and gratifying work and look forward to ensuring that every person with serious illness receives high quality palliative care.
When I was a medical student at UCSF, I heard stories from attendings about practicing in a world without antibiotics. It was almost impossible to imagine caring for patients without such an essential treatment. Thank you to the student who thought the same about palliative care and to the scores of dedicated people who have made it impossible to imagine a world without palliative care and who have made it a much better world with it.