"I couldn’t just turn my back on cancer patients who had completed their experimental therapy. Palliative care is a part of comprehensive, good cancer care. I have grown as an individual by knowing many patients and families from all walks of life. It makes me a better doctor.”Institution
--Frederick J. Meyers, MD
West Coast Center for Palliative Care Education and Research
The hospice program at UC Davis serves about 70% cancer patients and 30% patients with nonmalignant disease.Principal Investigator
Joan Blais, MPA
Program Mission and Objectives
To enhance the science and art of palliative care.
The West Coast Center for Palliative Care Education and Research will be a regional, national and international asset and resource for palliative care. Palliative care reduces the violence of life-limiting illness. Palliative care is a philosophy of care delivery by an interdisciplinary team, which combines active and compassionate therapies. The West Coast Center for Palliative Care Education and Research assembled a multidisciplinary faculty to:
The palliative care team is composed of oncologists, nurses and social workers. The program can refer to other providers as needed. The team also includes educators and health services researchers.
Patients entering the investigational cancer therapy program are assigned a nurse and a social worker who oversee both their chemotherapy and their palliative care—from symptom control to helping the patient and family prepare for death. Patients come to the hospital for treatment, but reside at home.Historical Perspective
At the same time, Meyers and his colleagues were considering more end-of-life care outreach. They started a prison hospice program at the California Medical Facility at Vacaville. At this time, before the introduction of life-prolonging drugs, as many as 30 prisoners per week were dying from AIDS. The NCI hospice education grant, along with the prison outreach program, allowed Meyers and his colleagues to formalize their plan and make a commitment to introducing palliative care earlier in the disease process.
Because of the long tradition of hospice care at UC Davis, medical center leaders supported the concept of a palliative care program. The center already had been providing end-of-life care for a number of years without a hospice benefit. In addition, in 1991, Meyers had been appointed chief of hematology and oncology. In 1997, he became chief of medicine and retained his position as medical director of the hospice. Meyers is a rarity in that he is both a department chair and a hospice medical director, which makes him the ideal program champion.
Meyers and his colleagues did not have to overcome the integration challenges faced by many other palliative care programs. The hospice was already in place within the center and was providing clinical care. Rather, their challenge was to be more than hospice—that is, to develop models that systematized palliative care throughout the disease process. Yet another challenge was research. The hospice had significant experience in education after all those years of medical students rotating through, but Meyers was not an experienced health services researcher and had to learn how to measure outcomes, a task which is at the heart of the program.Research
The education component of the original hospice program continues. Today, students from all over the country visit the center.
Frederick Meyers sees the West Coast Center as one element in what will become a multi-institutional approach to simultaneous care.
Eventually, marketing will be needed.
The West Coast Center is funded by grants and philanthropy.
It is Meyers’ vision to develop models for improved care throughout the health care system, not just in cancer. Eventually, he hopes to expand the model developed by the West Coast Center for Palliative Care Education and Research to include heart failure patients and COPD patients.
The West Coast Center is also part of Meyers’ overall vision to bring palliative care to underserved populations. The investigational cancer therapy patients and the prisoner at Vacaville are two examples. Meyers and his colleagues have also started a rural palliative care initiative.
After finishing the simultaneous care study and establishing a framework for the program to continue, Meyers hopes to investigate other areas in palliative care such as the doctor–patient relationship and distress management.A National Perspective
“I wish I had known the resources available from health services researchers—people who know about what we are trying to do because they have been through it before with other types of efforts. The struggles are the same.”
--Frederick J. Meyers, MD
This descriptive summary is based on an interview conducted by Jane Grant Tougas with project staff in January and February 2001.
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