Palliative medicine consult service, Henry Ford Hospital
The inpatient service was established in 2000 and is an active teaching/consultative service, which rounds on approximately 10-20 patients/day and performs 60-80 consults each month. As part of an interdisciplinary team, fellows will provide comprehensive palliative medicine consults for patients with diverse diagnoses and across multiple clinical settings, including the ICU, general inpatient floors, and emergency department. Fellows take a leading role in teaching medical students, residents, and other trainees rotating on service.
Site Directors: Kristen Chasteen M.D., Leslie J. Bricker M.D., FAAHPM, FACP and Irena Zmitrovic, M.D.
VA Medical Center, Detroit
Fellows gain direct management experience in caring for patients nearing the end-of-life by working as part of an interdisciplinary team to provide comprehensive care for veterans in the VA long-term care hospice unit. Fellows also provide inpatient palliative medicine consultation and may help transition veterans from the inpatient to the hospice setting. Fellows take a leading role in teaching medical students, residents, and other trainees rotating on service.
Site Director: Michael Stellini M.D., M.S.
Hospice of Michigan:
Hospice of Michigan is a non-profit hospice agency serving greater than 1700 patients per day. Fellows work with interdisciplinary teams to provide end-of-life care to adult patients receiving home hospice services. Fellows do home visits with all members of the interdisciplinary team to learn about each team member’s role and expertise. Fellows also spend time working with the hospice medical director to learn about the clinical and administrative roles of the hospice physician.
Site Director: Evan Fonger M.D.
Angela Hospice is a non-profit hospice agency serving pediatric and adult patients, with a 32-bed hospice unit. Fellows work with interdisciplinary teams and gain direct management experience caring for patients at the end-of-life in the care center.
Site Director: James Boal M.D
Fellows work with a pediatric palliative medicine interdisciplinary team to see inpatient and outpatient palliative medicine consults, primarily at Children’s Hospital of Michigan. Fellows may also do home visits for pediatric palliative medicine patients.
Site Director: Nadia Tremonti M.D.
Fellows have weekly ambulatory palliative medicine clinic during rotations at Henry Ford Hospital. Fellows provide symptom management and advance care planning for patients with cancer and other serious illnesses. Fellows have the opportunity to follow patients longitudinally and across clinical settings.
Clinic Preceptors: Kristen Chasteen M.D., Leslie Bricker M.D. FAAHPM, FACP and Irena Zmitrovic, M.D.
Fellows have 6-weeks of elective time which includes time to complete a scholarly project and additional clinical rotations. Elective choices include anesthesia pain service, radiation oncology, behavioral health, neurology, heart failure, advanced pulmonary disease, and HIV medicine. Other electives can be accommodated based on fellow interest.
Structured learning occurs for 2 hours every week on Wednesday morning. In July and August, didactics and accompanying reading focus on the core topics in clinical palliative medicine to give fellows a solid foundation. During the remainder of the year, structured learning includes monthly journal club or complex case conference as well as didactic presentations.
Fellows also participate in a structured communication skills curriculum, CLEAR Conversations, which was developed at Henry Ford and has roots in the national VitalTalk organization. Fellows attend three communication skills workshops throughout the year, which utilize improvisational actors to allow fellows to practice skills in a safe environment. Fellows also have the opportunity to assist with teaching communication courses for residents. Fellows consistently receive structured feedback on their communication skills in real clinical encounters.
National and regional meetings:
Fellows have protected time and financial support to attend the Annual Assembly of the American Academy of Hospice and Palliative Medicine (AAHPM) and the Hospice and Palliative Nurses Association (HPNA) as well as the Palliative Care Collaborative Regional Conference. Fellows may also attend other local, regional, or national conferences depending on interest.
Interactive didactic presentations are given on research methodology in hospice and palliative medicine as well as quality improvement. Fellows have protected time to complete a scholarly project and work on a quality improvement project with faculty mentorship.