Success Stories From the First Tipping Point Challenge

March 10, 2020

New York, NY (March 10, 2020) – From January 2019-December 2020, CAPC held the first John A. Hartford Tipping Point Challenge. Over 1500 organizations met the Challenge. 24 organizations won and another 70 achieved the Honor Roll. A remarkable 15,000+ clinicians enhanced their training by completing 149,000 courses. The competition challenged participants to be more ambitious in their thinking and facilitated the spread of skills across specialties and disciplines. Organizations and leadership tackled the issue of spreading skill on an enterprise-level, enabling them to continue scaling improvement in the care they deliver to this patient population. Read their stories. . .

Since joining CAPC in 2015, Snowline has utilized CAPC’s numerous tools to educate our staff and our community. All of the courses have helped to strengthen our clinician’s skillset in both our home-based and hospital-based palliative care programs. The state of the art technology and content have replaced our previous online training format, and staff report that the courses are helpful and applicable to their practice Snowline Hospice and Supportive Care, Tipping Point Challenge Winner

After gaining leadership engagement in palliative care with the approval to purchase CAPC membership, leaders were eager to leverage this product. With our palliative care team’s close relationship with the hospitalist group, we were able to integrate CAPC modules as part of the hospitalist provider quality metric bonus incentives. Then we worked with internal medicine residency program, the emergency department, geriatrics, and cardiology which implemented this on a smaller scale. CAPC modules are the first education tools that we recommend to anyone who shows an interest in palliative care or serious illness management. Disciplines have included nursing, social work, care management, spiritual care, physicians, nurse practitioners, physician assistants, etc. We hope to engage critical care and ambulatory providers next! Cone Health, Tipping Point Challenge Honor Roll recipient

In response to the growing needs in our community, the UPMC Cole Home Health and Hospice nurses were seeking more in-depth education on caring for individuals with serious illness. The learning modules provided by CAPC allowed our nurses the opportunity to educate themselves as part of their annual education all the while enhancing their knowledge of symptom management and disease progression. The modules were assigned and the staff was able to complete them at their convenience. I believe this education improved their ability to manage symptoms and control pain for our palliative patients thus improving their quality of life. UPMC Cole Home Health and Hospice Services, Tipping Point Challenge Honor Roll recipient

Our facility had recognized the need for further education on palliative care being provided, for improving the quality of life for the patients and residents. Becoming members of CAPC provided staff with the educational modules to improve communication techniques for discussing patient and resident wishes – for symptom control of their conditions as well as advance directive conversation. The modules provided insight on pain management to address symptoms without fear of addiction, which was a relief for the nursing and medical staff, and patients and residents. Discussions between disciplines about the Tipping Point Challenge   and CAPC modules was engaging, and improved participation in ongoing education. Van Duyn Center for Rehabilitation and Nursing, Tipping Point Challenge Honor Roll recipient

Our team at Optum provides palliative care services through a variety of programs including telephonic, in home, and clinical based. We have clinicians with variable skills in palliative care. Our commitment to high quality palliative care starts with our onboarding and using the CAPC courses as part of the curriculum. Every new clinician is required to complete CAPC courses in serious illness communication, disease management (heart failure, COPD, dementia), and others. This ensures everyone starts with a strong foundation for providing the best care possible to our seriously ill patients across the country. ProHEALTH/Optum Supportive Care, Tipping Point Challenge Honor Roll recipient

We engaged clinical directors and clinical team leaders by sharing the benefits of the CAPC courses in person and then via email, encouraging them to share and promote this valuable resource with their teams. Subsequent to that, initially each month the directors were informed of our monthly reports, which initially did not show that our staff were taking advantage of the resource. They were encouraged to continue to promote use with their team leaders. As more and more of our staff began utilizing the resources we celebrated with positive and appreciative emails. Additionally, some teams made it mandatory part of their orientation plan. Hospice of the Western Reserve, Tipping Point Challenge Honor Roll recipient

Palliative Care Leadership at Moffitt Cancer Center has sought to develop the department according to evidence-based standards and national guidelines that define excellence in our field. As such, we have been recognized by The Joint Commission with Advanced Certification in Palliative Care. Certification requires orientation and continuing education for interdisciplinary team members to build and demonstrate knowledge and skills in the domains of quality palliative care. As we worked to maintain certification, CAPC was identified as an ideal resource for online modules to support our perpetual learning and best practice.

To foster competencies, we set expectations for our advance practice professionals and fellows to complete CAPC courses. The participants touted the engaging and excellent content. As this feedback was shared among interdisciplinary team members, social workers and chaplains also took these courses, soon making CAPC course completion a standard for palliative care team members and all other Moffitt outpatient social workers. The courses also became a routine part of our onboarding protocol for each new teammate. To encourage primary palliative care delivery by non-specialists, we enthusiastically promoted utilization of CAPC resources by all clinicians at our center. We ensured access via our ongoing CAPC institutional membership and also touted the benefits of obtaining specific CAPC Designations. The value was clearly recognized and CAPC Designations were adopted as criteria for professional advancement of registered nurses and advance practice professionals throughout Moffitt. Over time, Moffitt Oncology researchers seeking funding for studies regarding palliative care in oncology have been advised by grant reviewers to bolster their palliative care credentials.  Completion of CAPC courses helped to demonstrate competency in the field and obtain grants. The tipping point challenge spurred further course completion throughout the center. We are grateful to CAPC and The John A. Hartford Foundation for sponsoring the challenge to help palliative care and oncology teammates enhance their knowledge and skills to deliver the highest quality cancer care to those most in need. Moffitt Cancer Center, Tipping Point Challenge Winner

We integrated the CAPC modules into our APN and SW onboarding and also encouraged all of our >50 providers to register on the CAPC website and complete the education. AMITA Rainbow Hospice and Palliative Care, Tipping Point Challenge Honor Roll recipient

Our organization has embraced the CAPC online education offerings by using them to assist in enhancing our clinical competence. We have incorporated the education in our standard orientation and onboarding processes for our hospice and palliative care physicians, advanced practice nurses and physician assistants. In addition, we have utilized the education in the home based palliative service clinician training programs. We have encouraged our palliative clinicians to work towards the specific educational certifications offered by CAPC as well. We have also utilized the class / webinar education for specific topics. SCL Health – Lutheran Hospice and Palliative Care, Tipping Point Challenge Honor Roll recipient

We sent monthly reminders to all staff to complete modules, used the tracking report to monitor and update our staff and reported monthly to the Palliative Care team. Most of all having the conversation whenever we could, stressing the many benefits of completing the modules. As part of a grant project to bring palliative care to rural areas in North Dakota, we developed a team and action plan. Completing CAPC courses is part of our action plan so we send monthly reminders to staff, use the tracking reports, and report on progress each month at our palliative care meetings. McKenzie County Healthcare Systems, Tipping Point Challenge Honor Roll recipient

We engaged hospital leadership and all health care providers in the importance of palliative care education to better serve our patients with serious illness. We educated the staff on the CME availability through CAPC, and the courses on difficult conversations were placed in their “Net Learning”, which are required and highly suggested to be completed by the end of 2019. Also nursing designed a “friendly competition” – the most courses completed by a unit received a pizza party. Butler Health System, Tipping Point Challenge Winner

In 2019 the Coler team worked to strengthen and improve our palliative care program. It started with revamping our palliative care policy and palliative care plan. The largest component was staff education. As the CMO, I started with small education sessions with each department. At each session, I had a handout with screen shots and details of how to create a user name and password for CAPC. The Coler team was eager to complete more learning modules in CAPC once they completed the first module and realized the ease of use. They were also encouraged by the wealth of information and how the knowledge helped with their daily patient encounters. Coler Rehabilitation and Nursing Care Center, Tipping Point Challenge Winner

As an organization, we are very engaged in matters relating to the care of a frail and elderly population. The educational and professional development tools on CAPC have functioned as a true catalyst for that mission. Multiple departments and individuals in our organization have gone on to think critically and implement programs on how to care for older patients with dementia, those combatting loneliness, or those with end stage comorbid illnesses. CareMore Health, Tipping Point Challenge Winner

OSF HealthCare Saint Luke Medical Center is 25 bed Critical Access Hospital located in rural central IL, about 1 hour from tertiary care, with a strong mission of serving all those with the greatest care and love- The mission that our staff have chosen to partner with the Sisters of the Third Order of St Francis. Because of our strong faith and value of community we knew we needed to better serve those needing palliative care, as palliative care resources were not yet available in our rural community. Our systems Supportive Care Council reached out to all system hospitals, reviewed the CAPC resources with us, and challenged us to encourage our mission partners and providers to complete education. We spent time visiting departments discussing the importance, recruited Palliative Care Champions, set target dates, and reported completion rates. The most important thing that we did was tell stories of how the palliative tactics could impact our patients and their families — by sharing these stories, we were able to recruit many more. We recognized those that completed the education and celebrated our reward! OSF HealthCare Saint Luke Medical Center, Tipping Point Challenge Winne

CP Unlimited cares for 700+ individuals with intellectual and developmental disabilities (IDDs) in 125 certified residential homes, and has 100+ nursing staff, 5 registered dieticians, 20 mental health staff, and more than 1,000 direct care counselors. Approximately 20 of the RNs are case managers, however there was no consistency in the performance of their job functions. This has impacted not only the quality of nursing service, but also the other departments since they are interdependent. There was a need to maximize the professional performance of the RN case managers and provide more effective leadership in our participation in chronic care management programs (CCM) with their clinic providers.

By advocating Palliative Care delivery structure to improve the interdisciplinary team knowledge base, and for self-improvement (while achieving CMEs), staff from various boroughs responded to encouragement to try out the training modules. We are pleased with their achievement within 1 year of signing up with CAPC. This was achieved without allocation of protected time to do the courses. We plan to schedule additional training time this coming year. Having an outside and independent expert on palliative care to guide the team also gave the staff a sense of being treated equally by the team in terms of the importance of their work, regardless of their Boroughs, or their prior training and experience. Topics covered under CAPC are relevant to our staff. They are very happy to note that information on topics such as management of symptoms and dementia are easily available to them.

We do not have plan to form teams for billable palliative care service, but rather guide our staff on how and when to access palliative care in hospitals and homes, in a timely manner from existing agencies. We are confident that by working with CAPC, we will improve the quality of life of our IDDs and transform a challenging work place into a more supportive environment for our staff. OSF HealthCare Saint Luke Medical Center, Tipping Point Challenge Winne