February marked the 10-year anniversary of the launch of outpatient palliative care in the Palo Alto Medical Foundation’s Santa Cruz Division. Spearheaded by PAMF hospice specialist Sharon Tapper, M.D., and made possible by community donors, the program brings together interdisciplinary teams to provide specialized medical care for patients with serious, life-limiting illness.

Outpatient palliative care adds an extra layer of support on top of the clinical work already being done. While collaborating with oncology and other specialty groups, as well as primary care physicians, palliative care teams work to alleviate patients’ pain, stress and other symptoms while providing consultation and coordination for them and their families. They also offer psychosocial support to address patients’ hopes, worries and goals throughout the process.

Since launching in Santa Cruz, the program has spread throughout PAMF. Generous donor gifts helped build the Guzik Family Center for Geriatrics and Palliative Care in Palo Alto in 2015, the first expansion of outpatient palliative care beyond Santa Cruz. In the ensuing years, PAMF placed interdisciplinary teams in the Alameda and South Bay divisions and, in mid-2019, at PAMF Mills-Peninsula Division in San Mateo.

Northern Alameda County

Before passing the leadership reigns to palliative care physician Steve Lai, M.D., Dr. Tapper laid the groundwork to grow the program beyond PAMF to serve Sutter Health patients in northern Alameda County. In 2019, the Stupski Foundation awarded our integrated healthcare network a three-year $3.5 million grant to expand the Palliative and Advanced Illness Care program, bringing the four pillars of care coordination—specialty palliative care, advance care planning, family caregiver support and links to social services—to thousands more Sutter Health patients.

Thanks to the grant, Sutter East Bay Medical Foundation placed five team members on the Alta Bates Summit Medical Center campus last year. These caregivers help patients facing serious disease navigate the medical system in a way that honors their values and wishes as they set goals of care. For each of them, this is a labor of love.

“Our role is to listen, to hear what is important to a patient when they are struggling with disease and may not feel like themselves anymore,” explains Andrea Thatch, M.D., PAIC leader at ABSMC. “We are lucky to have an empathetic team, each one a star who goes the extra mile to advocate for patients and their loved ones.”

Contrary to what many people assume, palliative care services are available to patients with serious illness no matter where they are in the course of disease. “I want to deconstruct the myth that palliative care comes when there are no other choices,” says Lisa Edwards, LCSW, social worker on the PAIC team. “We don’t have an agenda for care, but the team offers many services that improve patients’ quality of life.”

Telemedicine Further Extends Reach

Across all medical disciplines, the COVID-19 pandemic drove rapid adoption of telemedicine to maintain patient access to high-quality care. Despite the restrictions brought on by the pandemic, telehealth actually allowed PAMF palliative care teams to increase their reach, serving 10% more patients. The East Bay program is slated to expand soon by adding a new team to support Eden Medical Center.

To help overcome challenges brought on by the pandemic, the Stupski Foundation awarded Sutter Health palliative care an additional grant of $225,000 last year. The funds provided mobile-enabled iPads for video consults and access to an advanced care planning video library to enhance patient care and improve planning for inpatient and ambulatory palliative care teams across Sutter Health’s Bay Area footprint.