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University of California - Davis, School of Medicine
Researchers at the University of California, Davis, School of Medicine and the West Coast Center for Palliative Education, in Sacramento, improved end-of-life care for some of California's hardest to reach populations with the Simultaneous Care project. Simultaneous Care expanded and improved the level of palliative care available to people in three isolated rural areas — Colusa, Tuolumne and Plumas Counties — as well as within the state's women's prison population.
According to the project's Principal Investigator, Frederick J. Meyers, M.D., professor and chair of Internal Medicine at UC Davis, though each of the targeted populations are dissimilar in many ways, each lacks access to palliative or hospice care. People living in these three rural communities and women dying in the state's prisons directly benefited from the outreach programs established via this project.
Palliative care focuses on comfort and the psychological, social and spiritual well-being of dying individuals and assists patients and their families with the difficult, but normal, challenges of facing life's end. Within this project, palliative care experts trained teams of health providers to work in the rural counties and to use teleconferencing links to UC Davis physicians for immediate assistance in the care of dying patients. Using remote television, UC Davis physicians viewed patients and offered suggestions for care. Additionally, health care workers in the women's correctional institutions received palliative care training to provide better care for female inmates who were dying.
Another component of the program provided palliative medical services to UC Davis Cancer Center patients who chose to participate in experimental cancer clinical trials, which usually make them ineligible for hospice services. This improved the patients’ quality of life while they were undergoing experimental therapies.
The researchers evaluated the impact of their interventions and education on the quality of care, as well as the quality of life of patients served.
After the Grant
The Simultaneous Care program continued with a federal grant funding a five-year multi-site randomized control trial. Project researchers replicated the rural component’s telemedicine conferencing for other diagnoses. The women’s prison designated hospice beds for dying inmates when the project ended.
Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families.