Evaluating the California Hospital Initiative in Palliative Services.
BACKGROUND
Inpatient palliative care programs can improve care of patients with serious illness. We developed the California Hospital Initiative in Palliative Services (CHIPS) program to assist hospitals in establishing these programs. CHIPS included an introductory conference followed by 10 months of mentoring with telephone calls, e-mails, on-site consultation at the hospital, and a reunion conference.


METHODS
To evaluate CHIPS and the factors associated with establishing inpatient palliative care programs, we conducted a cross-sectional telephone survey of leaders from the 38 hospitals that participated in CHIPS. We assessed the number of inpatient palliative care consultation services established by hospitals that participated in CHIPS (success) and hospital characteristics associated with success.


RESULTS
Participants gave CHIPS high ratings. Six hospitals (16%) had a palliative care consultation service at enrollment in CHIPS and 19 hospitals (60%) established one after participation in CHIPS (P<.001). In bivariable comparisons, successful hospitals were more likely to have a hospitalist program (P = .003) or to be located in an urban setting (P = .03).


CONCLUSIONS
CHIPS seemed to help many hospitals establish inpatient palliative care programs. Hospitals with hospitalists and those in an urban setting were more likely to succeed in developing palliative care programs. Future studies should focus on the quantity and quality of care provided by these programs.
Pantilat
Steven Z
SZ
Department of Medicine, University of California at San Francisco, 94143-0903, USA. stevep@medicine.ucsf.edu
Rabow
Michael W
MW
Citko
Judy
J
von Gunten
Charles F
CF
Auerbach
Andrew D
AD
Ferris
Frank D
FD
D002140:California; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006757:Hospital Units; D016304:Hospitals, Private; D006801:Humans; D007297:Inpatients; D020380:Needs Assessment; D016017:Odds Ratio; D009937:Organizational Objectives; D010166:Palliative Care / Q000458:organization & administration*; D011336:Probability; D016730:Program Development; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D017749:Total Quality Management; D014504:Urban Health