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

A. ORIGINAL TOOLS FROM PROJECT SAFE CONDUCT:

The print-friendly versions of these tools are in downloadable Adobe Acrobat PDF format. If you wish to download the free Adobe Acrobat Reader, go to the Adobe website.

1.    Pain Management Care Path [Print]

2.     Pain Flow Sheet [Print]

B. WEBSITES RELATED TO THIS ISSUE'S CONTRIBUTORS:

American Hospital Association (AHA)
www.hospitalconnect.com/aha/awards-events/circle_of_life/index.html
AHA is a key sponsor of the 2002 Circle of Life Award. Visit this site for more information about this year's award and/or to apply for next year's award. Applications for the 2003 award are due on August 12, 2002.

The Children's Program
www.chsd.org/body.cfm?id=35&action=detail&ref=48
The Children's Program is a joint endeavor between San Diego Hospice and Children's Hospital of San Diego. The program functions on a referral/consult basis and conjoins the palliative medicine strength of a well-known state-of-the-art hospice with the pediatric expertise of a Children's Hospital. Parts of the program are housed at both sites. Its strength lies in the ability to be flexible in meeting the needs of children and families in its care, resulting in parent-driven and parent/child-focused innovative programs of care.

Dana-Farber Cancer Institute
www.dfci.harvard.edu
The mission of Dana-Farber Cancer Institute is to provide expert, compassionate care to children and adults with cancer while advancing the understanding, diagnosis, treatment, cure, and prevention of cancer and related diseases. The Institute is a teaching affiliate of Harvard Medical School.

Hospice of the Bluegrass
www.hospicebg.com/
Hospice of the Bluegrass (HOB) got its start in the late 1970s as a community-focused volunteer effort to help the terminally ill in Fayette County (KY) die with dignity. They have maintained that strong focus on community, expanding today to care for people at ten different sites in 23 counties across central, southeastern, and northern Kentucky. Its services are broad and provided through an interdisciplinary team approach that includes registered nurses, home care aides, social workers, chaplains, bereavement counselors, volunteers, and physicians, as well as the patient's own doctor.

Hospice of the Western Reserve
www.hospicewr.org
Based in Ohio, Hospice of the Western Reserve is the sixth largest hospice in the United States. The hospice collaborated with the Ireland Cancer Center at Case Western Reserve University to develop the AHA Circle of Life Award-winning program, Project Safe Conduct, featured in this issue of Innovations.

Ireland Cancer Center
University Hospitals of Cleveland and Case Western Reserve University
www.irelandcancercenter.org/
www.uhhs.com
Ireland Cancer Center (ICC) is a National Cancer Institute comprehensive cancer center based out of Case Western Reserve University and the University Hospitals of Cleveland. ICC collaborated with Hospice of the Western Reserve to develop Project Safe Conduct, an AHA Circle of Life Award-winning program focused on making palliative care accessible to persons suffering from advanced lung cancer even as they may be pursuing life-prolonging treatments.

Medical College of Virginia— Virginia Commonwealth University
Division of Hematology/Oncology
views.vcu.edu/internal-medicine/inm/hematology.html
Dr. Thomas J. Smith chairs this division. This page has links to their fellowship training program and to the End-of-Life Curriculum for M3s (third-year medical students during their Medicine rotation) at www.curriculum.som.vcu.edu/medicine/endoflife/Overview.html The end-of-life curriculum pages include the curriculum, expectations for student work, sample student compositions as well as articles, essays, poems and links to other useful resources.

Population-based Palliative Care Research Network (PoPCRN)
www.uchsc.edu/popcrn/
Based in the Division of General Internal Medicine at the University of Colorado Health Sciences Center, the Population-based Palliative Care Research Network (PoPCRN) conducts rigorous end-of-life research in settings where palliative care is provided. The PoPCRN approach to improving end-of-life care is innovative in that it represents a spectrum of models in diverse settings. The program's wide collaborative reach ensures that the issues being studied are clinically relevant and that the studies themselves are rigorous and high quality.

Project Safe Conduct
www.irelandcancercenter.org/PatientCareTeamsICC-thoracic-safeConductTeam.htm
Project Safe Conduct is the name given to the collaborative venture between Hospice of the Western Reserve and Ireland Cancer Center featured in this issue of Innovations. The project derived its name from Avery Weisman's book, Coping with Cancer, in which he defines safe conduct as "the dimension of care that guides a patient through a maze of uncertain, perplexing, and distressing events." One of the 2002 Circle of Life Award winners, Project Safe Conduct focuses its services on patients suffering from advanced lung cancer.

Promoting Excellence in End-of-Life Care
www.promotingexcellence.org
A national program office of The Robert Wood Johnson Foundation with direction and technical assistance provided by the Practical Ethics Center at the University of Montana. Promoting Excellence is currently funding 22 projects to improve palliative care in different parts of the United States, including Project Safe Conduct. To read more about Project Safe Conduct, go to the list of grantees and click on the section for "Specific Diseases and Terminal Conditions." Scroll down to Ireland Cancer Center. To access a set of working documents on "Integrating Cancer Care and Palliative Care," click on the list of products and find the descriptive summaries of the Strategic Retreat held June 4, 2001 in Chicago. Ten groups participated in this retreat including Ireland Cancer Center/Project Safe Conduct.

C. OTHER RELEVANT WEBSITES:

American Cancer Society
www.cancer.org
The American Cancer Society is a nationwide, community-based voluntary health organization. Founded in 1913, ACS has chartered divisions throughout the country and over 3,400 local offices committed to fighting cancer through balanced programs of research, education, patient service, advocacy, and rehabilitation. In partnership with ACS, the National Comprehensive Cancer Network has recently published its first version of the Lung Cancer Treatment Guidelines for Patients. The guidelines include information on early detection and evaluation of cancer, staging, and side effects of various treatments.

Cancer Care
www.cancercare.org
Cancer Care is a US-based national nonprofit organization whose mission is to provide free professional help to people with all cancers through counseling, education, information and referral, and direct financial assistance. See the Lung Cancer section at www.cancercare.org/types/lung/index.asp and the Palliative Care: Pain and Symptom Management at the End of Life page at www.cancercare.org/managing/pain/pain_17969.asp.

Cancer Control:
Journal of the Moffitt Cancer Center
www.moffitt.usf.edu/pubs/ccj
Peer-reviewed bimonthly journal that is accessible and free online. A number of past issues are particularly relevant: "Oncologic Support and Care," Volume 8, Number 1, January/February 2001, "Lung Cancer," Volume 8, Number 4, July/August 2001, "Cancer Pain Management," Volume 7,Number 2, March/April 2000, and "Oncology Support and Palliation," Volume 6, Number 2, March/April 1999.

Edmonton Palliative Care Program
www.palliative.org/
The Edmonton Palliative Care Program site is organized for both professional and non-professional audiences, offered by the Division of Palliative Medicine, Department of Oncology, University of Alberta, Edmonton, Canada and The Edmonton Regional Palliative Care Program. Content includes clinical information, patient assessment tools, cancer material, and links to related resources. See the archived issue of Innovations Quality of Life for an in-depth description of their efforts to integrate palliative care into the care of all persons in that region facing the end of life. The Edmonton Regional Palliative Care Program has been particularly successful in reaching patients suffering from advanced cancer, with referral to palliative care services occurring among approximately 85 percent of these patients. [Fainsinger R. Addressing quality of life at the Edmonton Palliative Care Program: An interview with Robin Fainsinger, by AL Romer. Innovations in End-of-Life Care. 2000;2(6), www.edc.org/lastacts.]

Health Evidence Bulletins - Wales
hebw.uwcm.ac.uk/
Health Evidence Bulletins - Wales is a collaborative project involving Health Authorities, providers of primary and secondary health care, and library and information units. This site offers summaries (in PDF format) of best evidence for a range of diseases. This page for lung cancer was completed in 1998, under the guidance of team leader Dr. Gordon Avery and can be found at hebw.uwcm.ac.uk/cancers/chapter1.html.

Institute of Cancer Research
Research Groups: Center for Cancer and Palliative Care Studies
www.icr.ac.uk/ccpcs/
Based in the United Kingdom, the Institute of Cancer Research investigates the causes of cancer and develops new strategies for its prevention, diagnosis, treatment and cure. Click on the Publications link for a search function and list of cancer management and nursing publications. Visit the Research Groups page for a description of the Macmillan Practice Development Unit (MPDU) aims and list of Centre for Cancer and Palliative Care Studies undertaken as well as a targeted set of references.

LungCancer.org
www.lungcancer.org
This comprehensive site includes pages for patients and caregivers as well as health care professionals, with information on all aspects of the disease—including palliative care.

National Cancer Institute (NCI)
www.cancer.gov
The National Cancer Institute is a component of the National Institutes of Health (NIH), one of eight agencies that compose the Public Health Service (PHS) in the Department of Health and Human Services (DHHS). This site includes a huge amount of information, including many useful documents about specific cancers. For an overview of cancer information available, see cancer.gov/cancer_information/.

NCI plans, promotes, and carries out an ambitious program of disease-specific research, charting its course through advice from expert Progress Review Groups (PRGs). The PRGs are panels of 20-30 prominent members of the scientific, medical, and advocacy communities that assess the state of the science for a single type of cancer or group of closely related cancers and make recommendations for future research. Reports from the Progress Review Groups are at prg.cancer.gov/index.html, including the August 2001 Report of the Lung Cancer Progress Review Group.