Rural Project Examples: Hospice and palliative care

Evidence-Based Examples

Project ENABLE (Educate, Nurture, Advise, Before Life Ends)
Updated/reviewed December 2022

Need: To enhance palliative care access to rural patients with advanced cancer or heart failure 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 higher quality of life and lower rates of depression and (caregiver) burden.

Care for Our Elders/Wakanki Ewastepikte
Updated/reviewed June 2022

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.

Garrett County Regional Cancer Patient Navigator Program
Updated/reviewed March 2020

Need: Comprehensive cancer services for residents of an 8-county, 3-state area in Appalachia.
Intervention: Using a Cancer Patient Navigation Tool Kit, a Maryland acute care facility led a multidisciplinary collaboration that provided the area's patients with expanded cancer treatment services.
Results: In addition to several new cancer-related programs, expanded services are now available for cancer patients, families, and cancer survivors.

Trinity Pioneer ACO
Updated/reviewed December 2019

Need: Transitioning from fee-for-service models to valued-based payment models in rural Iowa.
Intervention: In 2011, the Trinity ACO was formed in rural Iowa after being selected by the Center for Medicare and Medicaid Innovation as 1 of the 32 planned Medicare Pioneer Accountable Care Organizations.
Results: Now part of the Next Generation ACO, Trinity continues to bring attention to rural-specific organizations using its focus on palliative medicine and effective strategies to distribute value-based services.

HopeWest
Updated/reviewed May 2019

Need: To provide easily-accessible and affordable services to address the challenges associated with aging, serious illness and grief across Western Colorado's rural 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 has helped more than 22,000 hospice patients and families in need and has grown to serve five counties.

For examples from other sources, see: