Harvard Medical SchoolCenter for Palliative Care

PAPC

(#732740-1701)

Directors

Kristen G. Schaefer, MD
Eva H. Chittenden, MD

When

Thursday-Saturday
September 15-17, 2016

Where

Royal Sonesta Hotel
Cambridge, MA

Brochure

Download

Tuition

$895 physicians
$795 nurses, allied health professionals
$695 social workers, chaplains

CMEs

Earn up to 18.75 AMA PRA Category 1 Credits™

In Massachusetts
Opioid Education/Pain Management Credits: A maximum of 6.25
End-of-Life Care Credits: A maximum of 15.00

CNEs

A maximum of 18.75 contact hours will be awarded.

CEUs

Social Work CEUs are pending

PAPC

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PAPC Schedule

Please note: program changes/substitutions may be made without notice

Thursday       Friday       Saturday

To download a copy of the schedule, please click here.

*
  Qualifies for Opioid Education and Pain Management Training credits
ø
  Does not qualify for End-of-Life Care Education credits
  Covers topics required by the Massachusetts DPH that physicians registered with the state's Medical Use of Marijuana Program must complete as a condition to issuing written certifications to qualifying patients

 

 

Thursday - September 15, 2016

 

Time

 

Session

Faculty

7:15-8:00   Registration and Breakfast  
8:00-8:30   Welcome, Introduction, and Overview of the Course and Dayø Kristen G. Schaefer, MD
Eva H. Chittenden, MD
8:30-9:45 PL1 Plenary: Changing the Culture and Systems of Medicine to Improve Advance Care Planning Susan Block, MD
9:45-10:00   Break  
10:00-11:15   Breakout Session 1  
  1A Pharmacotherapy of Pain* (repeats at 2A) Elizabeth Rickerson, MD
Bridget Scullion, PharmD
  1B Talking about Serious News Kristen Schaefer, MD
Barbara Reville, DNP, NP, ACHPN
  1C The State of Palliative Nursing Constance Dahlin, ANP-BC, ACHPN, FPCN, FAAN
  1D Spiritual Care of Patients with Advanced Illness: Associations with Quality of Death and Medical Care at the End of Life Tracy Balboni, MD, MPH
Katrina M. Scott, MDiv, BCC-HPCC
  1E Home-based Palliative Care Julia M. Gallagher, MD
Martha Quigley, MS, GNP-BC
11:15-11:30   Break  
11:30-12:45   Breakout Session 2  
  2A Pharmacotherapy of Pain* (repeats at 1A) Elizabeth Rickerson, MD
Bridget Scullion, PharmD
  2B Decoding Code Status Discussions Eva H. Chittenden, MD
Leah Rosenberg, MD
  2C Opioid Misuse and Addiction in Palliative Care* Lida Nabati, MD
Joji Suzuki, MD
  2D Challenges in the Management of Advanced Dementia Helen Chen, MD
  2E Depression and Anxiety in Palliative Care David Yuppa, MD
12:45-1:45   Lunch on Your Own  
Top      
1:45-3:00 PL2 Plenary: Will You Still Need Me, Will You Still Feed Me, When I’m 104? Improving Palliative Care for Older Adults Helen Chen, MD
3:00-3:15   Break  
3:15-4:30   Breakout Session 3  
  3A Case-based Presentation of Non-Pain Symptoms in Palliative Care (repeats at 4A) Erica Wilson, MD
Kathleen P. Doyle, MD
  3B Delirium at the End of Life: Impact on Patients and Caregivers Mary K. Buss, MD, MPH
  3C Psychological Challenges in the Care of Young Adults Karen Fasciano, PsyD
  3D Case-based Ethical Dilemmas Ellen Robinson, RN, PhD
  3E Part 1 of 2: Using the Serious Illness Care Guide (must take both parts) Rachelle Bernacki, MD, MS
Justin J. Sanders, MD, MSc
Jo Paladino, MD
4:30-4:45   Break  
4:45-6:00   Breakout Session 4  
  4A Case-based Presentation of Non-Pain Symptoms in Palliative Care (repeats at 3A) Erica Wilson, MD
Kathleen P. Doyle, MD
  4B Palliative Care Emergencies Lara Michal Skarf, MD
  4C Working on an Inpatient Palliative Care Unit: Life on the Ground Day to Day Linda Drury, PA-C
Kate Baccari, PA-C
Courtney Moller, PA-C
  4D Ask the Professor: Discussion of Challenging Cases Janet Abrahm, MD
  4E Part 2 of 2: Using the Serious Illness Care Guide (must take both parts) Rachelle Bernacki, MD, MS
Justin J. Sanders, MD, MSc
Jo Paladino, MD
Top      

 

Friday - September 16, 2016

 

Time

 

Session

Faculty

7:15-8:00   Breakfast  
8:00-8:15   Overview of the Dayø Kristen G. Schaefer, MD
Eva H. Chittenden, MD
8:15-9:30 PL3 Plenary: Early Palliative Care: If It Works, Why Wait? Marie Bakitas, DNSc, NP-C, FAAN
9:30-9:45   Break  
9:45-11:00   Breakout Session 5  
  5A A Novel Approach to Late Goals of Care Conversations: REMAP (repeats at 6A) James Tulsky, MD
  5B "Difficult" Families Guy Maytal, MD
  5C Practical Aspects of Pediatric Palliative Care Shih-Ning Liaw, MD
  5D Identifying Opportunities for Collaboration between Oncology and Palliative Care Tracy Balboni, MD, PhD
Janet Abrahm, MD
  5E Interventional Approaches to Pain Management* Elizabeth Rickerson, MD
Mihir M. Kamdar, MD
11:00-11:15   Break  
11:15-12:30   Breakout Session 6  
  6A A Novel Approach to Late Goals of Care Conversations: REMAP (repeats at 5A) James Tulsky, MD
  6B "Difficult" Patients Guy Maytal, MD
  6C ABCs of Hospice Stephanie Patel, MD
Mary Beth Barry, RN, MSM, CHPN, CHPCA
  6D Managing Neuropathic Pain* Mihir M. Kamdar, MD
Shane J. Volney, MD
  6E Overcoming Barriers to Integrating Palliative Care in Community and Rural Settings Marie Bakitas, DNSc, NP-C, FAAN
12:30-1:30   Lunch on Your Own  
Top      
1:30-2:45 PL4 Plenary: Working with Referrers to Help Patients Cultivate Prognostic Awareness Vicki A. Jackson, MD, MPH
2:45-3:00   Break  
3:00-4:15   Breakout Session 7  
  7A Part 1 of 2. Misunderstandings about Prognosis: An Approach for Palliative Care Consultants When the Patient Does Not Seem to Understand What Was Said (must take both parts) Vicki A. Jackson, MD, MPH
Juliet Jacobsen, MD, DPH
Jane deLima Thomas, MD
  7B Palliative Care and End-stage Renal Disease Robert A. Cohen, MD, MSc
  7C Reflecting on End of Life through Poetry Amy Ship, MD
  7D Negotiating Conflict in the Family Meeting John Halporn, MD
Bruce MacDonald, LICSW
  7E Mind/Body Medicine in Palliative Care Ann Webster, PhD
4:15-4:30   Break  
4:30-5:45   Breakout Session 8  
  8A Part 2 of 2. Misunderstandings about Prognosis: An Approach for Palliative Care Consultants When the Patient Does Not Seem to Understand What Was Said (must take both parts) Vicki A. Jackson, MD, MPH
Juliet Jacobsen, MD, DPH
Jane deLima Thomas, MD
  8B Advanced Hospice Issues Joel Bauman, MD
  8C Managing Fatigue in Cancer Patients Carlos Fernandez-Robles, MD
  8D Medical Marijuana: Cannabinoid Pharmacology, Review of Scientific Evidence, and Suggestions for Clinical Practice Ilana M. Braun, MD
Lida Nabati, MD
Joji Suzuki, MD
  8E Best Practices in Bereavement Care Sue Morris, PsyD
Top      

 

Saturday - September 17, 2016

 

Time

 

Session

Faculty

7:15-8:00   Breakfast  
8:00-8:15   Overview of the Dayø Kristen G. Schaefer, MD
Eva H. Chittenden, MD
8:15-9:30 PL5 Plenary: Bereavement Interview and Structured Debrief Sue Morris, PsyD
9:30-9:45   Break  
9:45-11:00   Breakout Session 9  
  9A Conflict Resolution in the Interdisciplinary Teamø Erica Wilson, MD
Alison Rhodes, NP
Lynn Mazur, MSW
  9B Legislative Initiatives to Address the Opioid Crisis* Doug Brandoff, MD
  9C Existential Distress, Demoralization, and Dignity David Yuppa, MD
  9D Legal Aspects at the End of Life, Especially Withholding and Withdrawing Life Sustaining Treatments Rebecca W. Brendel, MD, JD
  9E Making Work Sustainableø Catherine Arnold, LICSW
Amanda Moment, LICSW
11:00-11:15   Break  
11:15-12:30 PL6 Plenary: Taking it Home James Tulsky, MD
12:30-12:35   Wrap-up Kristen G. Schaefer, MD
Eva H. Chittenden, MD
Top      

 

*
  Qualifies for Opioid Education and Pain Management Training credits
ø
  Does not qualify for End-of-Life Care Education credits
  Covers topics required by the Massachusetts DPH that physicians registered with the state's Medical Use of Marijuana Program must complete as a condition to issuing written certifications to qualifying patients
9E: Creating a sustainable work-life balance is an ongoing, iterative process that requires self-reflection and monitoring. In this interactive session, we will explore ways in which we can work toward greater sustainability in our practice and in our lives.
9D: This session will provide an overview of U.S. Constitutional Law governing end-of-life care with an additional focus on practical implications and broad principles affecting local practice.
9C: This session will focus on the topics of existential distress, demoralization, and dignity as they pertain to the treatment of patients with serious, life-threatening illness.
9B: This session will update participants on local, regional, and national opioid-related policies affecting patients, clinicians, dispensers, and payers. Through didactic teaching and participant discussion, we will also review the Massachusetts experience as a case study for legislative involvement in the opioid crisis.
9A: A hallmark of palliative care is the interdisciplinary team process. Given the challenges of developing a plan of care for patients with serious illness, there are times when conflict may arise within the palliative care team or across teams providing care to the patient. A model of conflict resolution based on shared values and ethics across disciplines can help to constructively resolve such conflicts.
8E: This session will provide an overview of the nature of grief from a psychological perspective. Guidelines and practical strategies for providing bereavement care will be outlined.
8D: These sessions will review the cannabinoid pharmacology, current state of scientific literature relating to medical marijuana, and considerations for clinical practice including substance abuse concerns. They will also review federal and state-level regulation regarding its use.
8C: This session will cover the evaluation and management of fatigue in patients with cancer. Latest recommendations for interventions and strategies to implement them will also be discussed.
8B: Advanced hospice issues.
8A: This two-part session will explore reasons why patients misunderstand the prognosis and teach participants communication strategies to partner with patients to discuss prognosis. You must take both parts.
7E: This session will introduce participants to several mind/body medicine techniques and will describe numerous studies illuminating the benefits of mind/body medicine strategies.
7D: This session will provide knowledge and skills on the conduct of a family meeting. This is an essential palliative care competency, although it is rarely taught. In this exercise, we will consider indications for this common procedure, create a map for a structured approach to leading a meeting, especially when conflict is present, and practice key skills.
7C: This session will allow participants to read poems and reflect collectively on the complex issues they address associated with palliative care and end-of-life care.
7B: End-stage kidney disease is associated with heightened morbidity and mortality. This session will provide prognostic information and tools that assist with identifying those at highest risk for doing poorly with the approach of end-stage kidney disease and the treatment options to consider for such patients. Additionally, it will address approaches for conducting conversations with such individuals that promote the likelihood that treatment decisions take into account patient values and preferences.
7A: This two-part session will explore reasons why patients misunderstand the prognosis and teach participants communication strategies to partner with patients to discuss prognosis. You must take both parts.
6E: This session will define community based palliative care and review the challenges and barriers that are present in accessing expert palliative care outside of the urban, academic settings. Innovative strategies such as telehealth and community health workers will be described as potential scalable solutions to these challenges.
6D: This session will be an interactive didactic that will provide a comprehensive, up-to-date review of neuropathic pain. The lecture will cover topics ranging from the basic science mechanisms that sustain neuropathic pain to the practical use of analgesic targeting neural pain.
6C: This session will review the philosophy behind hospice care, the basic eligibility criteria as well as review the myths and misconceptions which lead to barriers to referring patients to hospice.
6B: This session will provide learners with a practical approach to be more effective in challenging patient interactions. The session will train the learner to use their own reactions to difficult interactions as the access for better understanding and managing them.
6A: This session will introduce a "talking map" to guide clinicians through goals of care conversations. We will identify common pearls and pitfalls, and use a series of fun drills to practice common phrases and responses to difficult questions.
5E: This session will help participants understand the background and rationale for pain interventions in palliative care and cancer pain patients. We will focus on the importance of a pain diagnosis and discuss the risks and benefits of interventions in a population that is generally much sicker than the typical chronic pain population.
5D: This session will utilize case studies to highlight the role of palliative cancer therapies in patients with advanced malignancies; goals of care and quality of life; and using effective communication strategies between oncology providers and palliative care to assure continuity of care.
5C: This session will provide an overview of pediatric palliative care, highlighting epidemiological considerations, strategies for communication, and approaches to symptom management.
5B: This session will summarize the nature of family structures and dynamics that arise in palliative medicine settings. The session will also present methods and approaches to operating clinically when a family's behavior towards and understanding of clinical care does not match the mainstream expectations in medical practice.
5A: This session will introduce a "talking map" to guide clinicians through goals of care conversations. We will identify common pearls and pitfalls, and use a series of fun drills to practice common phrases and responses to difficult questions.
4E: This session will discuss the Serious Illness Care Program, which is a population management tool to improve the care of patients with serious and life-threatening illnesses by creating a system in which patients and families are engaged in appropriate discussions with their clinicians about end-of-life care preferences that can then be documented and honored across the care network. Must take both parts.
4D: This session will be a case-based discussion using challenging cases supplied by audience members. For each case, we will discuss the elements that make the case challenging, the heuristic(s) that would be useful, the pathophysiology if relevant, the aspects of suffering manifested by the case, the team approach to understanding that suffering, and to resolving it when possible and appropriate. Audience members will be invited to participate in the discussion of others' cases as well as their own.
4C: This session will present an interactive question and answer format using case studies to describe the day to day functioning of an inpatient palliative care team. A stable group of Physician Assistants, who have worked together for several years with very little turnover, share their experiences as the primary responding medical team working on an inpatient unit, providing symptom management to patients at every stage of their cancer course, from those undergoing curative treatments, to those at end of life. We will explore the logistics of day to day functioning, the challenges of working within a large academic medical center with multiple disciplines, and the idea of compassion fatigue and how to prevent it.
4B: This session will review practical management strategies for common urgent and emergent medical conditions that arise in a palliative care setting, including: seizures, catastrophic hemorrhage, a pain crisis, opioid-induced neurotoxicity and spinal cord compression.
4A: This session will be a case based presentation which reviews differential diagnosis and management of some non-pain symptoms commonly seen in Palliative Care such as nausea, dyspnea, bowel obstruction and fatigue.
3E: This session will discuss the Serious Illness Care Program, which is a population management tool to improve the care of patients with serious and life-threatening illnesses by creating a system in which patients and families are engaged in appropriate discussions with their clinicians about end-of-life care preferences that can then be documented and honored across the care network. Must take both parts.
3D: This session will focus on several ethical dilemmas that arise in palliative care, including the relevance of the doctrine of double effect and whether there is an ethical distinction between treatments that may be withheld versus withdrawn.
3C: This session will focus on the unique issues that young adults with life threatening illness encounter including developmental disruptions, altered life goals, threats to body integrity, and high levels of emotional distress. Participants will also be presented with common professional challenges in caring for these young patients, as well as strategies to increase developmental competence in their care delivery.
3B: Delirium is a highly prevalent and highly distressing condition for patients and their families in any setting, but especially as patients approach the end of life. This session will review predisposing and precipitating factors for delirium, introduce a variety of assessment tools to facilitate diagnosis and provide an evidence-based approach to the treatment, including both pharmacologic and non-pharmacologic strategies.
3A: This session will be a case based presentation which reviews differential diagnosis and management of some non-pain symptoms commonly seen in Palliative Care such as nausea, dyspnea, bowel obstruction and fatigue.
2E: This session will focus on the assessment, differential diagnosis, and management recommendations of depression and anxiety in the palliative care setting. Special attention will be paid to the unique clinical scenarios and specialized pharmacology of the palliative care patient. Less focus will be given to a detailed exploration of the various modes of psychotherapy applicable to this patient population.
2D: This session will explore the ways in which hospitalized patients with dementia present special challenges to inpatient clinical teams.
2C: This session will review the spectrum of substance use problems seen in the palliative care setting. One of the greatest challenges for the palliative care provider is managing patients with pain and concurrent substance misuse, particularly when the misused substance is the opioids prescribed for pain. We will review strategies to identify and manage patients with opioid misuse or at high risk for opioid misuse. We will also review how to manage pain in patients taking methadone or buprenorphine for opioid dependence.
2B: In this interactive session, we will discuss barriers to code status discussions and discuss survival statistics and outcomes after inpatient CPR, including data on the functional and cognitive status of survivors. Most importantly, we will discuss best practices in conducting these discussions and brainstorm ways to improve them, both from individual clinician and systems perspectives.
2A: This session will help participants understand the various kinds of pain and the classes of medications that are designed for pain treatment. We will discuss pain syndromes and targeted treatment with co-analgesic and adjuvant pain medications. We will also discuss opioid use and management.
1E: This session will: 1) Provide a general overview of the different organizational and staffing models for home-based palliative care including frequently encountered administrative and operational challenges posed by each model and; 2) Use patient vignettes from our own program to demonstrate the breath of palliative care needs in the community and the various clinical approaches as well as challenges to providing palliative care in this setting.
1D: This session will explore, from both historical and research perspectives, the role of religion/spirituality in advanced illness. This will include a review of qualitative and quantitative data regarding the role of religion/spirituality in quality of life, coping, and end-of-life decision making. The session will then review core principles of spiritual care provision, including spiritual care guidelines, spiritual assessment, and the role of the multidisciplinary spiritual care team.
1C: The maturity of Palliative Nursing mirrors the evolution of the specialty of palliative care. Palliative nurses are forging new roles, developing new programs, conducting innovative palliative research, and creating educational programs. This session will describe the art and science of palliative nursing within the spheres of clinical practice, education, research, and policy. Attention will be on both the registered nurse and the advanced practice registered nurse roles. Primary and specialty palliative nursing will be described. Current roles and examples of palliative nursing leadership will be highlighted.
1B: This session will provide a small group environment facilitated by a physician-nurse team in which participant interaction will support learning. Recognizing that serious illness discussions with patients are laden with emotionality and clinician stress, the facilitators will model communication behaviors and support participants during role play using practical strategies for broaching discussions of patient fears, hopes, goals and wishes for care at the end of life.
1A: This session will help participants understand the various kinds of pain and the classes of medications that are designed for pain treatment. We will discuss pain syndromes and targeted treatment with co-analgesic and adjuvant pain medications. We will also discuss opioid use and management.