Palliative Care
The Inland Empire Palliative Care Coalition
Taking on the Difficult Issues in Our Community
By Benjamin Mahdi, MPH
 On June 15, 2006, Emergency Medical Services transferred John Smith to the hospital after suffering a heart attack. Mr. Smith was 92 years old and had advanced Alzheimer’s disease. In prior conversations, Mr. Smith discussed his wishes for intensity of care with his primary care physician. He admittedly expressed no heroic measures were to be taken in the event of cardiac arrest. On his way to the hospital, Mr. Smith went into cardiac arrest and was subsequently intubated and admitted to the ICU. Due to the breakdown in communication, neither the emergency room doctor nor the EMS technician was aware of his wishes.  The lack of clear and adequate communication on end of life care between providers, patients, and facilities is just one major issue the Inland Empire Palliative Coalition is addressing.
Who is the Inland Empire Palliative Care Coalition?
In 2005, stakeholders of the Riverside and San Bernardino healthcare community joined efforts to address issues such as this and founded the Inland Empire Palliative Care Coalition (IEPCC). The IEPCC, a volunteer-run, nonprofit organization, operates under the Riverside County Medical Association and serves the Inland Empire community of Southern California. The IEPCC’s goals are:
- To educate the health care community about the unique nature of palliative care
- To promote collaboration among providers
- To expand palliative care programs to create awareness on the availability of palliative care programs
The Coalition’s mission is "To promote comprehensive high-quality and compassionate end-of-life care through increasing advance care planning and palliative care services, leadership in the development and advocacy of improved practices; and encouraging system-wide changes at the individual, organizational and community levels."
 What is Palliative Care?
Palliative care is a multi-disciplinary approach to patient care, addressing both medical concerns such as pain and symptom management, while also taking into account the importance of psychosocial and spiritual well-being. Palliative care treats the symptoms of disease when the potential for a cure is no longer a reasonable goal. Palliative care addresses a patient’s need at any age.
Conditions appropriate for this service are serious or life threatening illnesses and may include but are not limited to cancer, Chronic Obstructive Pulmonary disease (COPd), heart and lung disease, and dementia. When appropriate, palliative care complements treatment options, in the hospital setting, a palliative care program provides patients and families with access to a palliative care team.
The palliative care team is typically composed of individuals from multiple medical and social support systems, including nursing staff , religious clergy, social support providers, and a palliative care physician. Because palliation provides these essential support services, it is even more important for intervention to occur as early in the diagnosis period as possible.
What is the Coalition doing in your community?
The Coalition realized the need for clear and consistent communication between providers, patients, and facilities regarding end of life care. To address this issue, the IEPCC chose the Physicians' Orders for Life Sustaining Treatment (POLST) model developed by The Center for Ethics in health Care at Oregon health & Science university.
The POLST is a standardized form which a physician completes with his or her patient. The form travels with the patient through all points of care. using the POLST form ensures higher compliance with patients' end-of-life treatment wishes and increases communication regarding end-of-life care. This ultimately improves a patient’s quality of life and serves as a standardized approach to establishing a patient's wishes. Currently, the IEPCC has implemented the POLST form at two community hospitals, four nursing homes, one assisted living facility, local EMS, three hospices, and is looking to expand the program.
How do I get involved?
The Inland Empire Palliative Care Coalition's effectiveness relies on care physician. Because Coalition doing in your community? The efforts of its volunteer members and community support. The chair, Tarek Mahdi, Md, is a local family physician and assistant clinical professor at Loma Linda Medical School. Dr. Mahdi is board certified in Family Medicine and in hospice and Palliative Medicine.
You can find Dr. Mahdi at The Inland Empire Palliative Care Coalition's monthly meetings or one of the Coalition's seminars on issues relating to palliative care. These meetings are open to the community and all are welcome.
If you are interested in attending a meeting or have any questions, feel free to contact the Riverside County Medical Association at 951-686-3342 or by email at iepcc@rcmanet.org. Articles index
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