Hospice Interdisciplinary Group Meetings

The Interdisciplinary Group Meeting must be the focal point of combining the care into an individualized roadmap for the patient and family to get to the anticipated and desired discharge. The peaceful death at home. Care plan review and updating from all team members keeping the goals in front of you make the meeting purposeful. What are you doing to enhance the group meeting experience?

Hospice is unique in the healthcare industry. It is a service provided to persons and their families who are facing the most challenging time of their lives. They have been diagnosed with a terminal illness and given a life-limited prognosis of six months or less. An impending death would cause any of us to be anxious, have anticipatory grief, and be fearful.

In the drafting of the hospice benefit back in 1983, Medicare took the model of hospice care from the founder, Cicely Saunders, and created a structure that remains with few changes today. The hospice benefit has grown, and many providers have entered into the industry, there has been a lack of understanding of the Interdisciplinary Group's purpose and function.

The Interdisciplinary Group composition includes a physician, registered nurse, social worker, and counselor, as core team members. Responsibilities include care planning and coordination of services for the patient and the family or caregivers.

The purpose of the Interdisciplinary group meeting (IDG) is to have a formal setting to map out, update plans, and coordinate the patient's care and support for the family. The registered nurse is the driver or the coordinator of the care. He or she is the "air traffic" controller. Gathering all of the information from each team member and provider of care ensures services are relevant and appropriate for the goals and coordinates the delivery.

Psychosocial, arguably may be the most important members of the group. While facing mortality, we understand from the Kuebler-Ross model that there is anticipatory grief throughout the five stages of grief. Grief is not just for the family members, but the patient as well.

The social worker and spiritual counselor often have limited or no input for the patient and family during the meeting. Lack of engagement during the meeting may be due to visit frequencies that are insufficient to understand what is happening with the patient. The visits are not conducive to "finding out" what the patient or family is experiencing or feeling. Or it could be that the services are not structured to support or counsel, but to meet the required visit and have no identified purpose.

The physician in charge of medical oversight must be willing to guide and instruct the team in what to expect and plan for as the disease progresses.

The patient and family are pivotal in developing the plan of care. The Interdisciplinary Group meeting is an ideal time to incorporate their participation in developing the care plan, understanding their needs, and educating about medication management and disease processes. The team's collaboration with the patient and family can bring the care goals into focus and alignment of all who are involved in the patient's care.

During this unusual time of Covid-19 and telecommunications, it is an excellent time to bring patients and families into your Interdisciplinary group meetings. You can maintain patient confidentiality and encourage active input from the family.

Remaining focused on the Interdisciplinary Group's purpose and the required meeting is a step towards successful outcomes in meeting this requirement.

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