NHPCO NewsLine Summer 2020 - 17

pressure cuff, so I can see in real
time daily, their blood pressures.
It prevents some of that potential
for disease transmission and it
has been very easy to get
everybody to use this every day
and not to share.
I also have eight public health and
pre-PA interns from University of
Maryland that have been
indispensable in making outreach
phone calls daily. Every time they
call, these interns have been
tracking COVID-19 symptoms,
screening symptoms from the
caregivers, assessing for possible
caregiver burnout, giving advice
and support for using the
telehealth platforms, sharing
information, and preventing
isolation, of course. They have
been essential for that human
component.
I believe that I was able to master
that pivot because as a PA we are
trained as team players to work
hand in glove, not only with our
medical colleague doctors but
also our colleague NPS, skilled
nurses, home health agencies,
hospice RNs, and geriatric care
managers to just name a few.
Having this team approach is a
key consideration for virtual visits.
We can make life saving impacts
whilst significantly easing the
burden on the health systems
that populations rely on. This is
also an opportunity for PAs to
join us altogether in answering
the call as patients return home.
Many PA have been extensively
and rapidly cross trained and all

necessary specialties and are
ready to provide the continued
palliative and advanced illness
care from multiple sites using
telemedicine.

of the program. Our tele-support
team has been utilizing
telephonic care management for
10 plus years.
We have proven that adding
telephonic management of
patients can lead to improve
quality of life care outcomes and
reduce cost to the health care
system because we are helping
keep patients out of the
emergency room, the hospital
and the ICU with this method of
more ongoing care, and the focus
of our tele-support nurses really
is a continuation of what we do in
the home.

Rena Dhillon, RN
Rena Dhillon is with Sutter Health,
Advanced Illness Management
Program, Clinical Manager in
Concord & San Leandro Sutter
Health.
I am a registered nurse and I work
for a palliative care program as a
clinical manager. Our palliative
care program is an
interdisciplinary program led by
registered nurses and we provide
a mix of in-home and telephonic
visits to patients with advanced
chronic illnesses in the last 12
months of life. Our program's
largest arm is our tele-support
team which provides telephonic
case management to patients
who are typically our more stable
patients. When we get a new
patient, we start off with home
visits and once care is established
and the patient is more stable,
they move to our telephonic arm

One of the main things we do
involves goals of care and
advance care planning. It's really
important to make sure that we
understand what the patient and
family goals and wishes are and
that we have clear documentation
so that if something were to
happen, we would have that
identified and would know what
the patient wants.
Other things we focus on with
telephonic management are
symptom management and
medication management, which
are key to helping patients stay
safe and comfortable in the home.
Necessary for all of this to work is
building good rapport with your
patient - patient engagement is
one of those things that is key. If
the patient is not engaged or you
have not built a rapport, it is
difficult to have any of this play a
factor in what they are doing day
to day in their homes.

Newsline / Summer 2020

17
NHPCO NewsLine Summer 2020

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