Paterson, NJ [February 14, 2011] —ED Management, a national publication for emergency department directors, administrators, physicians and nurse supervisors on top of developments in the business and management of emergency medical care, recognized the Life-Sustaining Management and Alternative (LSMA) services, an innovative program of the Emergency Department at St. Joseph's Regional Medical Center in Paterson, NJ, with its Gold Star Award for going "above and beyond the expected to dramatically improve performance through unique and creative approaches." This unique program is designed to provide comfort, control and choices for chronic and terminally ill patients and their loved ones when faced with difficult end-of-life decisions. The honor was announced in the January 2011 issue of ED Management.
"At St. Joseph's, we are translating palliative care into the emergency setting," explains Dr. Mark Rosenberg, Chairman of Emergency Medicine at St. Joseph's Regional Medical Center. "Our goal is to help patients remain in control of their lives as much as possible, and help them understand their disease. We work with them to improve their quality of life through the relief of pain and non-pain symptoms while also providing emotional, social and spiritual support."
A recent study published in the New England Journal of Medicine proved that this approach to palliative care actually prolongs life and alleviates stress and physical pain. Those receiving palliative care from the start, the authors said, reported less depression and happier lives as measured on scales for pain, nausea, mobility, worry and other problems. Fewer of these patients opted for aggressive chemotherapy as their illnesses worsened and many more left orders that they not be resuscitated in a crisis. This group of patients typically lived almost three months longer than the group of patients getting standard care, who lived a median of nine months.
The LSMA team, led by Dr. Rosenberg and Ramazan Bahar, RN-BC, Emergency Department Nurse Coordinator, SJRMC, is available for consultations 24/7 through the St. Joseph's Regional Medical Center Emergency Department. The core team is comprised of a physician, nurse and social worker, with the addition of other specialists as needed. The initial evaluation reviews the patient and family's access to hospital and community resources such as medical specialties, pastoral care, home and respite care, and legal services that will help them live more comfortably and independently.
"Many patients are not aware of the trajectory of their disease and what to expect," adds Rosenberg. "This program gives Emergency Department physicians at St. Joseph's a course of action, a chance to not only relieve pain and suffering, but to communicate effectively and work with the patient and family to establish treatment goals that support and honor their wishes."
"St. Joseph's is the leading health resource in the community and for the community, and our mission is to provide a comprehensive spectrum of services designed to heal the minds, bodies and spirits of those in need, including those patients facing the end of life," says Sr. Maryanne Campeotto, Vice President, Mission, at St. Joseph's Healthcare System. "The Life-Sustaining Management and Alternative services program provided by the St. Joseph's Regional Medical Center Emergency Department team dovetails into St. Joseph's Healthcare System's comprehensive Palliative Care Program designed to provide highly specialized and compassionate care for patients facing progressive illness, as well as their families."
LSMA Patient Case Study: Staci
In September, Staci, a 25-year-old business owner was diagnosed with a brain tumor. She underwent two brain surgeries and chemotherapy. In November, she was told that there was nothing else that doctors could do; however, she did not understand that she was dying.
In early December, Staci arrived at the St. Joseph's Regional Medical Center Emergency Department due to a complication from the tumor. After talking with members of the ED's LSMA services team (in consultation with her neurosurgeon, oncologist and primary care physician), she realized that her life was ending, her cancer was terminal. Staci wanted to die the way she lived—with choices and in control. In the short time she had left, she worked with her family and medical team to identify realistic and concrete strategies and goals, such as getting her finances in order and spending a final Christmas with her loved ones. She concentrated on what was possible and what would make for a good ending to a great life.
Not only was Staci able to achieve her goals, but she died in the comfort of her home on December 28, knowing that she had made choices that allowed her to go in peace.