Laura Gelfman

Discipline: Physician

Funding awarded to: Icahn School of Medicine at Mount Sanai

TIER-PALLIATIVE CARE: A population-based care delivery model to match evolving patient needs to palliative care services for community-based patients with heart failure or cancer

Due to a limited specialty-trained palliative care workforce, patients often cannot access palliative care’s benefits, particularly in the community. Cancer and HF, the two leading causes of death in the US, are prototypical examples of the most common illness trajectories. The dynamic nature of these trajectories present distinct symptom patterns and changes in functional status that can create challenges with regard to the optimal palliative care delivery. To improve the quality of care for these populations, new models are needed to deliver community-based palliative care tailored to patient’s illness trajectory and changing needs. TIER-PALLIATIVE CARE (TIER-PC) is an innovative and adaptive model of delivering palliative care that provides the right level of care to the right patients at the right time. TIER-PC increases the number and intensity of disciplines added to the patient’s care team as their symptoms worsen and function declines. We will adapt and refine TIER-PC, test feasibility in a pilot RCT and then disseminate TIER-PC to improve access to palliative care for community-based patients with serious illness and match demand to the limited workforce.

“With each stage of my professional development, I have been passionate about using research to improve healthcare delivery to address the needs of seriously ill patients and their families. My career goal to become an independent investigator whose work focuses on creating novel patient-centered palliative care delivery models, which match the limited supply of specialty-trained palliative care clinicians to its increasing demand. With the data from this project and continued support of my mentors, I plan to obtain an R01 and become a national leader in palliative care research with a focus to improve high-quality palliative care delivery models for patients with serious illness that can be delivered in real-world settings to conserve limited resources (i.e. specialty-trained palliative care clinicians) and costs. The Sojourns Scholar Leadership Program will help me build my leadership identity and become better equipped to develop, test and disseminate innovative clinical palliative care models. By improving access to palliative care for patients within my health system and nationally, I will be well positioned for more leadership opportunities at the national and international levels.”