As the MGH celebrates the 20th anniversary of Palliative Care, Vicki Jackson, MD, chief of the Palliative Care and Geriatric Medicine Division, talks about the emotion of this milestone, the excitement of embarking on the division’s future projects and the challenges the unit has overcome.

How does it feel to celebrate 20 years of Palliative Care at the MGH?

It is very exciting! I’m very grateful that we have been able to, with the support of our colleagues and the institution, grow this service so tremendously in the last 20 years.

What comes to mind when you realize the unit has existed for 20 years?

It is really encouraging, and I have great anticipation of what the next 20 years will look like. We have had the gift of being so well integrated into the institution that now I’m really excited about what the next opportunities are. I don’t even think we could have envisioned this growth 20 years ago.

What are some major accomplishments the unit has achieved over the last two decades?

Our program has grown to one of the largest and most robust programs in the country. We have three different clinical services lines; inpatient consultation, outpatient palliative care clinic and home-based palliative care delivered in the community. We have pioneered the development of an outpatient palliative care practice that is deeply integrated into the care of patients with cancer.

Our research with Jennifer Temel, MD, clinical director of Thoracic Oncology and director of the Cancer Outcome Research Program in the Cancer Center, has shown that patients with metastatic lung cancer who receive early integrated palliative care have improved quality of life, a decreased rate of depression and a prolonged survival.

In research spearheaded by Areej El-Jawahri, MD, director of the Bone Marrow Transplant Survivorship Program, we have expanded our work in oncology to patients with leukemia undergoing bone marrow transplant. Patients undergoing bone marrow transplantation who have palliative care have improved quality of life and symptom control, a lower rate of depression, fewer post traumatic symptoms, and their family caregivers have improved outcomes as well.

What challenges has the unit overcome?

One of the biggest challenges is the workforce shortage in palliative care, and we’ve worked hard to build a large fellowship program for both nurse practitioners and physicians to meet that need. Nationally, there’s a very high rate of burnout in palliative care clinicians and we’ve worked hard to build a resiliency training program to help meet the needs of our clinicians, and also think about novel ways to improve the clinical delivery models that meet patient needs and support our faculty.

What does the future of Palliative Care at MGH look like? Anything new in the pipeline?

In 2015, Peter Slavin, MD, MGH president, convened a task force charged with developing a comprehensive strategy to care for seriously ill patients at the MGH. The task force began a nine-month strategic planning effort from which the Palliative Care Continuum Project was born with the mission is to help patients and families live well through palliative care, when and where they need it.

We have just begun the roll out of this program working with clinicians in primary care, hospital medicine, neurology, pediatrics and the emergency department. Palliative care scholars will be trained to serve as local palliative care experts, as we work to improve the care of seriously ill patients through a comprehensive advanced care planning strategy, patient and clinician education and engagement. This is something we are very excited about.

Where do you hope the unit will be in 20 more years?

I hope that in 20 years the division will be seen as a national leader in primary palliative care education as well as having expanded our research in oncology and other areas such as cardiology and neurology. I am so incredibly grateful to be at an institution where clinicians are focused on helping patients with serious illnesses live well.



Read more articles from the 02/17/17 Hotline issue.