Field of Work: End-of-Life Care
Problem Synopsis: During the 1980s and 1990s, Americans began to be concerned about the long period of suffering many people endured before their deaths. Little attention had been given to the need for continuity of care from acute-care services to palliative, end-of-life care.
Synopsis of the Work: From October 1998 to December 2003, with $450,000 from RWJF's Promoting Excellence in End-of-Life Care national program (as well as funding from the Cleveland Foundation, the Elisabeth Severance Prentiss Foundation and Case Western Reserve University [CWRU]) staff at CWRU, in partnership with Hospice of the Western Reserve and the Ireland Cancer Center at University Hospital, created Project Safe Conduct. Safe Conduct was defined as the dimension of care that guides a patient through a maze of uncertain, perplexing and distressing events. Safe Conduct's overarching goal was to eliminate the artificial boundaries separating acute care from end-of-life care by providing "safe conduct" for patients with terminal illnesses. Safe Conduct served 221 patients with advanced lung cancer.
Project staff reported the following results:
The national program office reported that the rate of admissions to Ireland Cancer Center declined by 67 percent after Project Safe Conduct began, and that lung cancer patients averaged 3.2 hospital admissions in the year before Project Safe Conduct started. Starting one year after Project Safe Conduct and every year thereafter, lung cancer patients averaged 1.05 admissions per year.