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Community-Based Palliative Care

Opening Plenary:
Community-Based Palliative Care

Martha L. Twaddle, MD, FACP, FAAHPM

Palliative care has been enjoying significant growth in the US during the past several years, primarily within hospital settings. This approach has significant value and there is now ample evidence showing positive outcomes for patients receiving hospital-based palliative care. Waiting for a hospitalization to trigger discussions of goals of care, however, may lead to unnecessary suffering. Intervening earlier in continuum of care for patients with chronic and advanced illnesses can significantly reduce the burden of illness, improve quality of life and prognosis as well as reduce overall healthcare expenditures, while at the same time, aligning expense with meaningful care. Thus increasingly community-based models of palliative care are emerging. Hospice programs are well versed in providing home-based services to patients with far advanced illness and their families in an interdisciplinary, holistic manner that attends to multiple facets of need; physical, emotional, social and spiritual. Involving the interdisciplinary team earlier in the care of patients with advanced illness presents unique challenges and requires new competencies and systems of care delivery.

This plenary will explore community-based palliative care; discuss models in operation and the outcomes that are being realized. Dr. Twaddle will encourage programs to expand their vision of care to include community-based palliative care models and to advocate for their development and integration into other models of healthcare delivery. Ensuring patients and their families have access to care options that best meet their individual needs is the goal; community-based palliative care is a viable model for those with advanced illness.

At the completion of this session, participants will be able to:

  • Discuss the vital continuum of hospital-  and community-based palliative care models
  • Describe successful models of community-based palliative care
  • Discuss the opportunities and challenges for the expansion of community-based palliative care from the existing model of hospice care.
  • Highlight some of the financial models that support home and community-based palliative care.

Martha L. Twaddle, MD, has joined JourneyCare as Senior Vice President of Medical Excellence and Innovation. Prior to holding this position, she was the Chief Medical Officer of Midwest Palliative & Hospice CareCenter in Glenview, Illinois, where she has served as hospice medical director since 1989 and helped grow the organization into a world-class leader with a keen focus on educating other physicians and healthcare professionals. Her unique talents and contributions to the field have helped to increase the understanding of and access to hospice and palliative medicine, locally, regionally, and nationally. In 2013, she was named one of the 30 most influential visionaries in hospice and palliative medicine by the American Academy of Hospice and Palliative Care.

After graduating summa cum laude from Purdue University, Dr. Twaddle received her medical degree from the Indiana University School of Medicine in Indianapolis, and completed a residency in internal medicine through Northwestern University Feinberg School of Medicine at Evanston Hospital, where she was also Chief Resident. She is certified by the American Board of Internal Medicine and the American Board of Internal Medicine for Hospice & Palliative Medicine. She is currently an Associate Professor of Medicine at Northwestern University Feinberg School of Medicine.

Dr. Twaddle has helped to facilitate the growth and development of hospice and palliative care on the national level. She served as President of the American Academy of Hospice and Palliative Medicine (AAHPM) from 2002-2003 and the AAHPM Board of Directors from 1997-2004. She received the inaugural AAHPM Josefina B. Magno Distinguished Hospice Physician Award in 2005. In 2004, she served on the Steering Committee for the National Consensus Project (NCP) for Palliative Care, which published the groundbreaking “Clinical Practice Guidelines for Quality Palliative Care.” In 2011, she was appointed to U.S. Senator Mark Kirk’s (R-IL) Health Policy Advisory Board as well as the Accreditation Council for Graduate Medical Education standing panel for accreditation appeals in the subspecialty of hospice and palliative medicine.

Other notable appointments include the Board of Directors of the National Hospice and Palliative Care Organization (NHPCO) 2008-2010, the Clinical Advisory Board member for the Cancer Wellness Center in Northbrook, Illinois, the Editorial Board of the Journal of Pain & and Symptom Management, and a peer reviewer for Journal of Palliative Medicine as well as for Palliative Medicine.

In 2006, Dr. Twaddle was honored in the naming of the first Midwest Palliative & Hospice CareCenter endowed chair, the Martha L. Twaddle, MD, Chair of Palliative Medicine. Dr. Twaddle is the first physician to occupy the chair, which is the highest honor the organization can bestow upon a physician. She received the Stephen A. Weisman Humanitarian Award for Cancer Care in 2001 from the Cancer Wellness Center. Dr. Twaddle also was the recipient of a 2008 Outstanding Alumni Award from the Purdue University College of Science. She was the 2012 honoree for Services for Adults Staying in Their Homes (SASI), a nonprofit organization serving adults in Chicago’s north and northwest suburbs.

Dr. Twaddle is active in research, speaks regularly to local and national groups, and has been published extensively in peer-reviewed articles and other publications on the importance and benefits of hospice and palliative medicine. She is an attending physician at Northwestern Memorial Hospitals, Northwestern Lake Forest Hospital, and Northwest Community Hospital, and senior attending physician at the hospitals of NorthShore University HealthSystems.