Skip to main content

Rural Project Examples: Hospice and palliative care

Evidence-Based Examples

Project ENABLE (Educate, Nurture, Advise Before Life Ends)
Added May 2017
  • Need: To enhance palliative care access to rural patients with advanced cancer and their family caregivers.
  • Intervention: Project ENABLE consists of: 1) an initial in-person palliative care consultation with a specialty-trained provider and 2) a semi-structured series of weekly, phone-delivered, nurse-led coaching sessions designed to help patients and their caregivers enhance their problem-solving, symptom management, and coping skills.
  • Results: Patients and caregivers report lower rates of depression and burden along with higher quality of life.

Promising Examples

Proactive Palliative Care and Palliative Radiation Model: Making MyCourse Better
Updated/reviewed July 2017
  • Need: To provide palliative care to patients with stage 4 cancer.
  • Intervention: The Emily Couric Clinical Cancer Center in Charlottesville, Virginia, has implemented a three-part program to help these patients manage their symptoms.
  • Results: The Proactive Palliative Care and Palliative Radiation Model enrolled 646 patients during its three-year funding period of 2012-2015.

Other Project Examples

Rugby Community Paramedic Program
Added November 2017
  • Need: Low patient volumes, a shortage of EMS volunteers, and an aging population in a 5-county North Dakota region required a change in the way the Rugby EMS team delivered care.
  • Intervention: Through the Rugby Community Paramedic Program, EMS staff bring medical care to patients transitioning back into their homes, including those with chronic conditions and hospice patients.
  • Results: The program's early intervention methods helped reduce the number of emergency room admissions and the escalation of medical conditions. Patient satisfaction has improved and the program has gained the trust of patients and medical staff in Rugby and surrounding areas.
Care for Our Elders/Wakanki Ewastepikte
Updated/reviewed June 2017
  • Need: To provide Lakota elders with tools and opportunities for advance care planning.
  • Intervention: An outreach program in South Dakota helps Lakota elders with advance care planning and wills by providing bilingual brochures and advance directive coaches.
  • Results: Care for Our Elders saw an increase in the number of Lakota elders understanding the differences between a will and a living will and the need to have end-of-life discussions with family and healthcare providers.
HopeWest Hospice
Updated/reviewed May 2017
  • Need: To provide easily-accessible and affordable hospice, palliative care, and grief services to patients and families facing life-threating illnesses in Colorado's Western Slope counties.
  • Intervention: A nonprofit, community-sustained healthcare model was created to address serious illness care and grief needs of adults and children.
  • Results: Since 1993, HopeWest Hospice has helped more than 18,500 patients and families in need and has grown to serve five counties.
Care Partners of Cook County
Updated/reviewed April 2017
  • Need: To provide holistic, interdisciplinary palliative care to those with chronic illnesses in rural hospitals in Cook County, Minnesota.
  • Intervention: Care Partners of Cook County created a palliative care program that utilizes local healthcare professionals and volunteers to provide universal care to patients and caregivers, without Medicare hospice status.
  • Results: Since its inception in 2010, the program has assisted over 185 residents in need.
Trinity Pioneer ACO
Added November 2015
  • Need: American healthcare is transitioning from fee-for-service models to valued-based payment models, and communities could fall behind the changing national trend.
  • Intervention: The Trinity ACO was formed in rural Iowa after being selected by the Center for Medicare and Medicaid Innovation as 1 of the 32 Medicare Pioneer Accountable Care Organizations.
  • Results: Trinity continues to focus on palliative medicine, produce effective strategies in distributing value-based services, and works closely with government bodies to construct federal ACO methodology, especially when it comes to rural-specific organizations.