Eickemeyer, associate director for The Joint Commission's certification program, says that for some hospitals, making allowances for such a program may seem too far a leap. "Internal financing can be an obstacle," because there is no billing code for palliative care at present. "How much is the leadership willing to support this when it's not a money making idea for the hospital."
He gives this example of the type of patient who would benefit with palliative care in a hospital with advanced certification. "A patient with multiple co-morbidities is admitted on a Friday, but on Saturday, the family comes for a visit.
"After visiting hours, the floor nurse finds the patient in obvious emotional distress (for no apparent reason). An advanced palliative care team would know what to do, would ask the right questions: Is this patient in need of pain medication or upset because of something that came up with the family. The advanced program can assess the person any time of day or night to get the right resources."
Sean Morrison, MD, director of the National Palliative Care Research Center and a director of the Hertzberg Palliative Care Institute at the now certified Mt. Sinai, said that over the past 11 years, "we've seen a dramatic increase in the number of hospitals that say they have palliative care teams," from almost none to 63% of all hospitals and 80% of hospitals with 300 beds or larger.