Harvard Medical SchoolCenter for Palliative Care

PAPC

(#351740)

Directors

Kristen G. Schaefer, MD
Eva H. Chittenden, MD
Susan D. Block, MD

When

Thursday-Saturday
September 17-19, 2015

Where

Royal Sonesta Hotel
Cambridge, MA

Brochure

Download

Tuition

$875 physicians
$675 nurses, allied health professionals
$575 social workers, chaplains

CMEs

Earn up to 18.75 AMA PRA Category 1 Credits™

In Massachusetts
Opioid Education/Pain Management Credits: A maximum of 5.0
End-of-Life Care Credits: A maximum of 18.75

CNEs/CEUs

Nursing CNEs and Social Work CEUs are pending

PAPC

Join Our Mailing List

Follow us on Twitter
@HMSPallCare

PAPC Schedule

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

Thursday       Friday       Saturday

Sessions which qualify for Opioid Education and Pain Management Training credits are marked with *
All sessions qualify for End-of-Life Care Studies credits, except those marked with °

 

Thursday - September 17, 2015

 

Time

 

Session Name

Faculty

7:15-8:00   Registration and Breakfast  
8:00-8:15   Welcome, Introduction, and Overview of the Course and Day° Kristen G. Schaefer, MD, FAAHPM
Eva H. Chittenden, MD, FACP
8:15-9:30 PL1 Plenary: The Role of Palliative Care for Heart Failure Patients with Cardiac Devices Nathan E. Goldstein, MD
9:30-9:45   Break  
9:45-11:00   Breakout Session 1  
  1A The State of Palliative Care Nursing Constance Dahlin, ANP-BC, ACHPN, FPCN, FAAN
  1B Talking about Serious News Kristen Schaefer, MD, FAAHPM
Barbara Reville, DNP, CRNP
  1C Pharmacotherapy of Pain* Mihir M. Kamdar, MD
Elizabeth Rickerson, MD
  1D Identifying Opportunities for Collaboration between Oncology and Palliative Care Tracy Balboni, MD, PhD
Kathy Selvaggi, MD, MS
  1E Home-based Palliative Care Julia M. Gallagher, MD
Martha Quigley, MS, GNP-BC
11:00-11:15   Break  
11:15-12:30   Breakout Session 2  
  2A Opioid Misuse and Addiction in Palliative Care* Lida Nabati, MD
Joji Suzuki, MD
  2B Decoding Code Status Discussions Eva H. Chittenden, MD, FACP
  2C Managing Neuropathic Pain* Mihir M. Kamdar, MD
Shane J. Volney, MD
  2D Discussing Prognosis and Goals of Care in Advanced Heart Failure Nathan E. Goldstein, MD
  2E Depression and Anxiety in Palliative Care David Yuppa, MD
12:30-1:30   Lunch on Your Own  
Top      
1:30-2:45 PL2 Plenary: A Randomized Controlled Trial of a Structured Tool to Elicit Goals and Values: The Serious Illness Care Program Rachelle E. Bernacki, MD, MS
2:45-3:00   Break  
3:00-4:15   Breakout Session 3  
  3A Delirium at the End of Life: Impact on Patients and Caregivers Mary K. Buss, MD, MPH
  3B Management of Common Non-Pain Symptoms in Palliative Care (Repeated at 4B) Erica Wilson, MD
Kathleen P. Doyle, MD
  3C Psychological Challenges in the Care of Young Adults Karen Fasciano, PsyD
  3D Mind/Body Medicine in Palliative Care Ann Webster, PhD
  3E Using the Serious Illness Care Guide Rachelle E. Bernacki, MD, MS
Justin J. Sanders, MD, MSc
4:15-4:30   Break  
4:30-5:45   Breakout Session 4  
  4A Palliative Care Emergencies Mary K. Buss, MD, MPH
  4B Management of Common Non-Pain Symptoms in Palliative Care (Repeated at 3B) Erica Wilson, MD
Kathleen P. Doyle, MD
  4C Working on an Inpatient Palliative Care Unit: Life on the Ground Day to Day Kristen Schaefer, MD, FAAHPM
Linda Drury, PA-C
Kate Baccari, PA-C
Courtney Moller, PA-C
  4D Palliative Care in the Homeless Population James J. O’Connell, MD
  4E Medical Futility: When is Enough Enough? Robert D. Truog, MD
Top      

 

Friday - September 18, 2015

 

Time

 

Session

Faculty

7:15-8:00   Breakfast  
8:00-8:15   Overview of the Day° Kristen G. Schaefer, MD, FAAHPM
Eva H. Chittenden, MD, FACP
8:15-9:30 PL3 Plenary: Addressing Healthcare Disparities in Advanced Illness Alexander K. Smith, MD, MPH
9:30-9:45   Break  
9:45-11:00   Breakout Session 5  
  5A 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, 5A and 6A) Vicki A. Jackson, MD, MPH
Juliet Jacobsen, MD, DPH
Jane deLima Thomas, MD
  5B "Difficult" Families Guy Maytal, MD
  5C Practical Aspects of Pediatric Palliative Care Shih-Ning Liaw, MD
  5D Legal Aspects at the End of Life, Especially Withholding and Withdrawing Life Sustaining Treatments Rebecca W. Brendel, MD, JD
  5E Interventional Approaches to Pain Management* Elizabeth Rickerson, MD
11:00-11:15   Break  
11:15-12:30   Breakout Session 6  
  6A 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, 5A and 6A) Vicki A. Jackson, MD, MPH
Juliet Jacobsen, MD, DPH
Jane deLima Thomas, MD
  6B "Difficult" Patients Guy Maytal, MD
  6C ABCs of Hospice Stephanie Patel, MD
  6D A Comprehensive Review of Methadone* Mihir M. Kamdar, MD
Bridget C. Scullion, PharmD
  6E Prognostication in Serious Illness Alexander K. Smith, MD, MPH
12:30-1:30   Lunch on Your Own  
Top      
1:30-2:45 PL4 Plenary: Palliative Care for the Surgical Patient Zara Cooper, MD, MSc, FACS
2:45-3:00   Break  
3:00-4:15   Breakout Session 7  
  7A Medical Marijuana: Current State of Medical Marijuana Research and Regulation Joshua Abrams, JD
Lida Nabati, 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 Conflictual Family Meetings in the ICU Kristen Schaefer, MD, FAAHPM
Philip Higgins, PhD, MSSW
  7E Managing Fatigue in Cancer Patients William F. Pirl, MD
4:15-4:30   Break  
4:30-5:45   Breakout Session 8  
  8A Medical Marijuana: Cannabinoid Pharmacology, Review of Scientific Evidence, and Suggestions for Clinical Practice Ilana M. Braun, MD
Joji Suzuki, MD
  8B Challenges in Management of Advanced Dementia Helen Chen, MD
  8C When Your Patient Asks: How Do I Talk with My Kids? Cynthia W. Moore, PhD
  8D Patient Requests to Hasten Death: Assessment and Management Susan D. Block, MD
  8E Sexuality Issues in Palliative Care Patients and Their Families Sharon L. Bober, PhD
Top      

 

Saturday - September 19, 2015

 

Time

 

Session

Faculty

7:15-8:00   Breakfast  
8:00-8:15   Overview of the Day° Kristen G. Schaefer, MD, FAAHPM
Eva H. Chittenden, MD, FACP
8:15-9:30 PL5 Plenary: Bereavement Interview and Structured Debrief Susan D. Block, MD
9:30-9:45   Break  
9:45-11:00   Breakout Session 9  
  9A Conflict Resolution in the Interdisciplinary Team° Erica Wilson, MD
Todd Hultman, PhD, ACHPN
Lynn Mazur, MSW
  9B Best Practices in Bereavement Care Sue Morris, MCP
  9C Existential Distress, Demoralization, and Dignity David Yuppa, MD
  9D 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
  9E Making Work Sustainable° Heidi Blake, MD
Amanda Moment, LICSW
11:00-11:15   Break  
11:15-12:30 PL6 Plenary: Does the Medicare Hospice Benefit Improve Quality and Decrease Costs? An Evidence-based Presentation Ziad Obermeyer, MD, MPhil
Top      
PL6: This session will review current debates regarding costs and utilization of end-of-life care in patients with poor-prognosis cancers.
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 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.
9C: This session will focus on the topics of existential distress, demoralization, and dignity as they pertain to the treatment of patients receiving palliative care.
9B: This session will provide an overview of the nature of grief and outline guidelines and practical strategies for providing bereavement care.
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.
PL5: In this session, a bereaved family member of a patient who died recently will be interviewed by an experienced clinician to explore the experience of the bereaved person with the patient's end-of-life care, the phenomenology of early bereavement, and clinical approaches to supporting people in the early stages of grief.
8E: This session will address how sexuality is a vital quality of life issue for patients and partners that is often under-addressed in a palliative care context.
8D: In this session, we will use a case study of a real patient who wrote a letter to his physician requesting aid in dying to analyze the complex influences on desires for hastened death, the approach to evaluation and treatment, and the ethical challenges in deciding upon appropriate care for this patient.
8C: This session will provide a framework for helping patients support their children’s resilient coping through a parent’s life-threatening illness. Open and age-appropriate communication will be discussed and defined, because parents frequently ask for ideas that go beyond "just be honest," or "just follow your child’s lead." The session format will include a combination of lecture and group discussion of cases.
8B: This session will explore the ways in which hospitalized patients with dementia present special challenges to inpatient clinical teams.
8A: Medical Marijuana: Cannabinoid Pharmacology, Review of Scientific Evidence, and Suggestions for Clinical Practice
7E: This session will cover the evaluation and management of fatigue in patients with cancer. Latest recommendations for interventions will also be discussed.
7D: In this interactive session participants will explore and practice a nuanced approach to communication with surrogates and families in the ICU when there is family conflict regarding goals of care. A case of a woman with metastatic pancreatic cancer and acute respiratory failure will be presented, and participants will be given strategies to pursue end-of-life discussions and decision-making with the family.
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 is designed to highlight which patients have the greatest likelihood of doing poorly on dialysis and provide tools to assist with decision-making about dialysis in frail individuals. In addition, the session will address end-of-life care for patients with advanced chronic kidney disease.
7A: Medical Marijuana: Current State of Medical Marijuana Research and Regulation
PL4: This session will review challenges and opportunities for working with surgeons to provide palliative care to surgical patients.
6E: This session will provide an open forum for discussing the role of prognosis and prognostication in the care of people living with serious illness. We will discuss clinical decisions that hinge on prognosis, methods for estimating prognosis, and approaches to prognosis communication.
6D: A Comprehensive Review of Methadone
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 two-part session will explore reasons why patients misunderstand the prognosis and teach participants communication strategies to partner with patients to discuss prognosis.
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 risk/benefit ratio for interventions in a population that is generally much sicker than the typical chronic pain population.
5D: Legal Aspects at the End of Life: Especially Withholding and Withdrawing Life Sustaining Treatments
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 two-part session will explore reasons why patients misunderstand the prognosis and teach participants communication strategies to partner with patients to discuss prognosis.
PL3: This session provide stories and evidence of racial and ethnic disparities in access, use, and outcomes among persons living with advanced illness. We will discuss approaches to addressing these disparities through care provided at the bedside and at a systems/policy level.
4E: Deciding when the use of life-sustaining treatment has become “futile” is the #1 issue faced by hospital ethics committees in the United States today. In this session we will explore the various meanings of the concept of futility and current efforts to resolve these dilemmas.
4D: This session will examine the service delivery model of the Boston Health Care for the Homeless Program, as well as studies on mortality and causes of death among homeless persons.
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: Management of Common Non-Pain Symptoms in Palliative Care
4A: Palliative Care Emergencies
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.
3D: This session will introduce participants to several mind/body medicine techniques and will describe numerous studies illuminating the benefits of mind/body medicine strategies.
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: Management of Common Non-Pain Symptoms in Palliative Care
3A: Delirium at the End of Life: Impact on Patients and Caregivers
PL2: 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 as they approach the end of life 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.
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 review why conversations in patients with advanced heart failure are particularly complicated and describe specific communication techniques to consider in working with these patients and their families.
2C: Managing Neuropathic Pain
2B: In this interactive session, we will briefly review the historic context of cardiopulmonary resuscitation, followed by current survival statistics after inpatient CPR. We will discuss possible outcomes of a code blue, including death immediately or after an ICU course, and survival with or without return to prior functional or cognitive level. Barriers, including clinician discomfort, lack of training, and time pressures, will be addressed. Finally, we will discuss best practices in code status discussions and brainstorm ways to improve these conversations, both from individual clinician and systems perspectives.
2A: 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.
1E: This session will briefly review the different organizational and staffing models for home-based palliative care and the implications of each model in terms of credentialing, billing, and the development of referral sources. We will then use our recent experience with the development of a home-based program and patient vignettes to review lessons learned and to characterize the breadth of palliative care needs we have seen in the community.
1D: 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.
1C: Pharmacotherapy of Pain
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: As the specialty practice of palliative care continues to evolve, so too has palliative nursing. Palliative nurses are forging new roles for both registered and advanced practice nurses, developing new programs, and conducting innovative palliative research and creating educational programs. This session will describe the current state of palliative nursing as it has evolved from nursing’s fundamental focus on quality of life to the current art and science of palliative nursing. Preparation for specialty palliative nursing practice, current roles, and examples of palliative nursing leadership will be highlighted.
PL1: This session will review the trajectory of patients with heart failure and the unique role that palliative care plays in the care of these patients. It will also review the role of advanced cardiac technologies and how the role of palliative care changes with regards to these devices.