Two-thirds of Californians and 22 of California’s counties have no access to community-based palliative care. Michael and client

So, who helps people with serious illness who are experiencing difficult symptoms like nausea, pain, constipation, breathlessness, anxiety, or depression? Who helps them make decisions about advance care planning, goal-setting, or end-of-life issues? Often it’s the healthcare practitioners at primary care clinics—many of whom work in remote areas with very little access to training and peer support.

These heroes are on the front lines, and it’s our nonprofit educational arm, ResolutionCare Fund, that we use to support and train them in palliative care skills and competencies.

Hollywood Squares: Virtual Training via Telehealth

 Echo session screenFor the past nine months, every other Tuesday at noon, people popped up on the monitor in our videoconferencing studio until it looked like an episode of Hollywood Squares. Coming from primary care clinics throughout the Humboldt County area, as well as Mendocino County, 35 healthcare practitioners of all levels, from MDs to MAs, participated in the program.For each of our sessions, palliative care experts from across the country presented short lectures and then offered their expertise, alongside the ResolutionCare team, as we discussed cases brought forward by our participants.The goal? To create a network of high-quality, inspired professionals able to provide community-based palliative care in rural communities throughout the state.

Technology Bridges Rural Isolation

To connect with these practitioners, we used the tele-mentoring model developed by the University of New Team in Echo meetingMexico’s Project ECHO (Extension for Community Healthcare Outcomes). The ECHO model uses videoconferencing as the tool that allows expert teams to conduct virtual clinics with community providers. In this way, primary care doctors, nurses, medical assistants, and other providers learn to provide excellent specialty care to patients in their own practices.

People-to-People Benefits

The benefits of this program, “Training Primary Palliative Care Champions,” as reported by the healthcare providers themselves, included:

• Improved ability to manage patients’ physical and mental symptoms
• Increased comfort and confidence in leading advance care planning and goal-setting conversations—as well as addressing end-of-life issues with patients and their families
• Reduced feelings of isolation, and a new feeling of support for a very difficult area of their work

The regular opportunity to check in with each other, seek advice and support, and share struggles was a significant benefit for all.

Heroes’ Roll Call

The following community clinics took part in the program:
• Redwoods Rural Health Center (Redway),
• Heart of the Redwoods Hospice (Garberville)
• K’ima:w Medical Center (Hoopa)
• Six Rivers Medical Center (Willow Creek)
• Ferndale Community Health Center
• Arcata Community Life Medical Center
• United Indian Health Services (Arcata)
• Redwood Coast Medical Services (Gualala and Pt. Arena)

The program was generously funded by these groups dedicated to improving the lives of people in our community:
· Partnership Health Plan
· California Health Care Foundation
· North Coast Grant Makers
· Union Labor Health Foundation
· Bertha Russ Lytel Foundation
· St. Joseph Health – Humboldt County
· Individual Donors

Stay tuned: we’ll have more to report in the coming months, as we expand the reach of our educational programs.