title: A Model for Effective and Efficient Hospice Care: Proactive Telephone-Based Enhancement of Life Through Excellent Caring, "TeleCaring" in Advanced Illness.
abstract: BACKGROUND
  A community-based non-profit hospice provider implemented "TeleCaring" as a quality improvement intervention to identify and take action on patient or caregiver needs or concerns, such as uncontrolled symptoms or prescription problems.
  
  
  METHODS
  We assessed the rate of acceptance of the intervention, intensity of the intervention, escalations of calls from Specialists to Nurses, and the effect of the intervention on utilization of clinical services, clinical miles traveled, and family satisfaction with care.
  
  
  METHODS
  TeleCaring consisted of daily proactive phone calls to patients and caregivers by Specialists and Nurses.
  
  
  RESULTS
  Eighty-eight percent of new home hospice patients accepted TeleCaring when offered. A total of 5.3% of calls by Specialists were escalated to Nurses. TeleCaring participants had lower utilization of clinical services compared with non-participants. Family satisfaction increased and clinical miles decreased across the organization after the implementation of TeleCaring.
  
  
  CONCLUSIONS
  TeleCaring is a viable method to proactively identify home hospice patient or caregiver needs and adjust clinical services accordingly.
authors.affiliation: Capital Caring, Merrifield, Virginia, USA. Electronic address: mdavis@capitalcaring.org.
authors.forename: Malene S
authors.initials: MS
authors.lastname: Davis
authors.affiliation: Capital Caring, Merrifield, Virginia, USA.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Harrison
authors.affiliation: Capital Caring, Merrifield, Virginia, USA.
authors.forename: James F
authors.initials: JF
authors.lastname: Rice
authors.affiliation: Capital Caring, Merrifield, Virginia, USA.
authors.forename: Alanna
authors.initials: A
authors.lastname: Logan
authors.affiliation: Capital Caring, Merrifield, Virginia, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Hess
authors.affiliation: Capital Caring, Merrifield, Virginia, USA; University of Utah, Salt Lake City, Utah, USA.
authors.forename: Perry G
authors.initials: PG
authors.lastname: Fine
authors.affiliation: Capital Caring, Merrifield, Virginia, USA.
authors.forename: J Cameron
authors.initials: JC
authors.lastname: Muir
mesh_terms: D017028:Caregivers / Q000523:psychology; D003142:Communication; D005190:Family / Q000523:psychology; D006699:Home Care Services / Q000706:statistics & numerical data; D017051:Hospice Care / Q000379:methods* / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D009726:Nurses; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D013038:Specialization; D017216:Telemedicine / Q000379:methods* / Q000706:statistics & numerical data; D013689:Telephone; D013997:Time Factors
keywords: Hospice; advanced illness; care model; telehealth; telehospice