Innovations in End-of-Life Care
an international journal of leaders in end-of-life care

The 2001 Circle of Life Award

This issue of Innovations in End-of-Life Care addresses the challenge of how to bring palliative care into the mainstream in an acute care hospital setting. We are featuring the recently established Department of Pain Medicine and Palliative Care (DPMPC) at the Beth Israel Medical Center (BIMC) in New York City, as the first and only such department in the United States. Its very existence is innovative and it has just won one of the 2001 Circle of Life Awards celebrating innovation in end-of-life care. In the Featured Innovation: Part I, Russell Portenoy, MD, describes the circumstances that led to it, its development, the success they have attained thus far as well as the challenges of sustaining such a department. As part of this effort, Dr. Portenoy invited Marilyn Bookbinder, PhD, RN, expert in quality improvement and the design and implementation of integrated care pathways, to design and implement a pathway for imminently dying patients at Beth Israel. The result is the Palliative Care for Advanced Disease (PCAD) pathway, which has been piloted in three units at BIMC. The Featured Innovation: Part II, provides a detailed picture of the evolution of PCAD, an effort to document, measure, and improve palliative care in several inpatient units at Beth Israel.

The author of the editorial, John Ellershaw, MA, FRCP, notes that the very notion of "diagnosing dying" in a hospital setting where cure is the operative word, makes this effort worthy of our interest. A British expert on the design and use of integrated care pathways for patients who are dying, Dr. Ellershaw explains how and why integrated care pathways are an important new tool for clinicians working in palliative care around the globe. In the International Perspectives department, Innovations further examines the topic of how to integrate palliative care into hospital and community systems of care, in an interview with Stein Kaasa, MD, PhD. He describes the establishment of the Palliative Care Unit in Trondheim, Norway. We look forward to reading your comments to this thought-provoking issue in the Online Discussion. Dr. Bookbinder will serve as the online guest for the next couple of weeks.

Last year, Innovations developed three issues based on the three 2000 Circle of Life Award-winning programs (See Archives, Vol. 2, No. 3, 4, & 5). Now in its second year, the Circle of Life Award honors innovative programs that have improved the care people receive near the end of their lives, whether in the hospital, hospice, nursing home or at home in the United States. The award is sponsored by the American Hospital Association (AHA) in conjunction with the American Medical Association, the American Association of Homes and Services for the Aging, and the National Hospice and Palliative Care Organization. The award is supported by a grant from The Robert Wood Johnson Foundation. The Circle of Life Award will be given at the July 31, 2001 Health Forum Summit in San Diego, California. To read more about the award or to apply for next year, please visit the AHA page devoted to the award.

The Beth Israel's DPMPC is one of three programs to be honored with this year's Circle of Life Award. Click on the name of the institution for a summary of the program drawn from the executive summary and other materials submitted to AHA as part of the application for the award.

• Beth Israel's Department of Pain Medicine and Palliative Care

• Palliative Care Center of the North Shore

• St. Joseph's Manor, Compassionate Care Focus

The award selection committee also nominated six additional programs to receive Citations of Honor. These honorees come from all parts of the United States. They are:

Visit the AHA website to read short summaries of each of these programs.