Inpatient Units

I receive frequent questions about the role of inpatient units for palliative care or hospice in acute care hospitals.   There are a variety of opinions on the subject and just as many variations of unit design and structure.  In my hospital, Froedtert Hospital, the main teaching facility for the Medical College of Wisconsin, we started a "Virtual" inpatient unit six years ago to complement our consultation service.  The unit is a 24 bed general medicine ward for which Palliative Care has first call of beds; that is, whenever we need a bed, if the unit is filled, a non-palliative care patient is bumped to another unit.  We are not limited to a set number of beds.  All nurses on the unit have received palliative care training, several have received board certification.  The unit offers special amenties for palliative care patients and families in terms of space and services and there an interdisciplinary team approach with twice-weekly team meeting.  As part of the teaching mission, patients who come to the unit stay on the medical team of origin, but the Palliative Care Service has order writing priviliges and coordinates care.  The Virtual aspect of the unit gives us flexibility  in care options, but does not impose the burdens of needing to "fill beds" or manage the nursing and staffing logistics as in a fixed-bed palliative care/hospice unit.  This Virtual unit fits our needs quite well and has been used successfully at other teaching and community hospitals.  However, it is not necessarily the best fit for all hospitals.  If you would like more information or to discuss your own hospital's needs, visit my website, www.palliativecareeducation.com, or e-mail me, dweissma@mail.mcw.edu.