Evaluating the California Hospital Initiative in Palliative Services | End of Life | JAMA Internal Medicine | JAMA Network
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Original Investigation
January 23, 2006

Evaluating the California Hospital Initiative in Palliative Services

Author Affiliations

Author Affiliations: Department of Medicine, University of California at San Francisco (Drs Pantilat, Rabow, and Auerbach); California Healthcare Association, Sacramento (Ms Citko); and San Diego Hospice and Palliative Care, San Diego (Drs von Gunten and Ferris).

Arch Intern Med. 2006;166(2):227-230. doi:10.1001/archinte.166.2.227

Background  Inpatient palliative care programs can improve care of patients with serious illness. We developed the California Hospital Initiative in Palliative Services (CHIPS) program to assist hospitals in establishing these programs. CHIPS included an introductory conference followed by 10 months of mentoring with telephone calls, e-mails, on-site consultation at the hospital, and a reunion conference.

Methods  To evaluate CHIPS and the factors associated with establishing inpatient palliative care programs, we conducted a cross-sectional telephone survey of leaders from the 38 hospitals that participated in CHIPS. We assessed the number of inpatient palliative care consultation services established by hospitals that participated in CHIPS (success) and hospital characteristics associated with success.

Results  Participants gave CHIPS high ratings. Six hospitals (16%) had a palliative care consultation service at enrollment in CHIPS and 19 hospitals (60%) established one after participation in CHIPS (P<.001). In bivariable comparisons, successful hospitals were more likely to have a hospitalist program (P = .003) or to be located in an urban setting (P = .03).

Conclusions  CHIPS seemed to help many hospitals establish inpatient palliative care programs. Hospitals with hospitalists and those in an urban setting were more likely to succeed in developing palliative care programs. Future studies should focus on the quantity and quality of care provided by these programs.