By educating community members and physicians, Malene Davis and her team have increased hospice awareness.

Capital Hospice has provided end-of-life and palliative care for patients in Washington, D C and its suburbs in Northern Virginia and Prince George’s County, Maryland, for 30 years, longer than almost any other hospice in the country. This experience, partnered with the recent appointment of Malene Davis, founder of 20-year-old Hospice Care in West Virginia, to president and CEO, puts Capital Hospice in the lead for setting the standard in both service areas.

Malene Davis

“We focus on programming and reprogramming our staff about the level of service we want to provide our patients,” said Davis. “We want to provide a higher quality of service to the families, patients, and physicians in our area by increasing our community involvement and enhancing our service and educational offerings.”

Levels of care
Although all hospice care is palliative, not all palliative care is hospice. One arm of Capital Hospice’s organization, Capital Palliative Care Consultants (CPCC), addresses the pain-management and symptom-control side of the community’s need. CPCCs are Capital Hospice employees whose jobs include being hospice medical directors. In addition, they identify patients who are not yet at the level of need hospice patients require. Davis said these physicians open the door to the community for people who may not have otherwise made the decision to enter hospice.

“Our board-certified palliative care doctors visit these patients,” said Davis. “Our doctors also do house calls and see patients in hospitals. Because of the frequency in which they consult patients and families, our doctors have the mindset and the time to have the kinds of conversations many physicians don’t.”

Davis compared these service offerings to those of a cardiologist. If a patient needs a heart transplant, they would call a cardiologist. In this instance, if a patient had a serious illness and was in pain, they would call one of the CPCCs for a consultation. “Sometimes we hear patients weren’t referred to hospice because the referring physicians didn’t think they were ready,” said Davis. “Capital Hospice has erased that belief. A person with a serious illness is always ready for our organization because we can fit them nicely into what we’re offering, whether it is palliative or hospice care.”

Along with palliative care, Capital Hospice is one of only three community-based sites in the US with a palliative medicine fellowship accredited to train community physicians. One of Davis’ goals with the fellowship is to bring in mid-career providers who did not learn through their initial curriculums in school how to care for those in the end-of-life stage. “We’ve had requests from mid-career physicians who want to do a fellowship with us to learn about hospice care today,” said Davis. “That interest and availability is an uncommon denominator because you don’t see this kind of program everywhere, but you certainly see it here.”

24/7 services
Technology plays a role in the quality of care Capital Hospice provides to its patients and families. The hospice is one of the only in the country with an after-hours call center staffed by RNs trained to handle problems over the phone for caregivers and patients in crisis. The program was established in January 1994 and goes hand-in-hand with the organization’s five-year-old computerized system of charting, Sun Coast Solutions.

Each nurse and physician at Capital Hospice uses a laptop as a venue to provide live information about patients and their families to any provider within Capital Hospice’s system. When a patient is seen on Monday evening, that information is immediately entered in the system; if a problem develops early Tuesday morning, the triage nurse has the patient’s information and can respond accordingly.

“The computer is especially helpful in emergency situations,” said Spencer Levine, communications director. “Nurses have access any hour of the day or night to the latest chart or information. Families do not have to worry about what their loved one is taking because the nurse has the information at his or her fingertips.”

As Capital Hospice celebrates its 30-year anniversary, the administration is concentrating on getting its message out to the community and training its staff to do the same. “We have an idea of how many patients we should be serving in our area, and it’s a moving target,” said Davis. “Because our emphasis is on pain management and symptom control, we want patients to know they can have the same level of quality care in our organization they had in their personal lives. The idea of people not knowing they can have that quality of care keeps us up at night, so we’re getting into the community and spreading the word about the kind of work we do.”