With special thanks to Jennifer Moore Ballentine, Executive Director, CSU Shiley Institute for Palliative Care
Across the nation and around the world, healthcare professionals on the front lines of the COVID-19 pandemic are fighting valiantly to treat illness, manage symptoms, and ease suffering for patients experiencing serious and life-threatening complications from the novel coronavirus.
And thanks to the CSU Shiley Institute for Palliative Care, housed at California State University, San Marcos (CSUSM)—initially created with funding from Archstone Foundation and other partners—those heroic healthcare professionals now have access to more than 20 palliative care courses and resources to support their efforts, all at no charge. In two months, more than 4,200 courses have been accessed.
These online courses can help healthcare professionals quickly build the basic palliative care skills that are critically needed to provide the best care for patients and families affected by the pandemic. Topics include communication, advance care planning, palliative care skills for generalists, crisis intervention strategies, self-care, and other relevant subjects. Courses are self-paced and can be completed anywhere, at any time.
There is strong evidence that online courses can be as effective as in-person learning. And online learning as a modality is even more critical at a time when much of the country is under orders to practice social distancing and stay home during the coronavirus pandemic.
The free courses and resources will be available through June 30, 2020 to anyone caring for patients and families during this crisis.
This is just one of many timely and inspiring examples of the continuing impact that Archstone Foundation’s past grants are making. And that’s one of the reasons we chose the CSU Shiley Institute for Palliative Care as the first in a new Point of View blog series we’re calling, “Where Are They Now?”
Periodically, we plan to revisit past grants to review key findings, provide updates, and share what we are learning with you. We hope you will find this practice as insightful and informative as we do.
Creating a Self-Sustaining National Resource
In 2012, Archstone Foundation awarded $450,000 over three years for the initial creation of what was then known as the CSU Institute for Palliative Care. In 2015, the project was awarded a continuation grant of $450,000 over three years to increase access to, and awareness of, palliative care by continuing to educate current and future healthcare professionals and the community through the courses established at the institute.
These grants were originally made in the hope that the institute could become a national resource in palliative care and be self-sustaining after Archstone Foundation support ended. As seen by the institute’s response to the COVID-19 pandemic and other examples highlighted below, both of these hopes have clearly come to fruition.
The name change occurred in 2019, when the institute was re-named as the CSU Shiley Institute for Palliative Care in honor of donor Darlene Shiley, after she gave an additional $2.6 million to support the institute’s important work.
The institute’s mission is to increase access to, and awareness of, palliative care by educating current professionals as well as the future workforce, and building community awareness and advocacy. The institute now offers 218 unique, web-based training courses and modules for nurses, social workers, chaplains, physicians, and multidisciplinary and specialty healthcare workers. Partnerships with other CSU campuses are integrating palliative care content into pre-professional curricula.
Since it was launched in 2012, the institute has provided online training courses to more than 12,000 healthcare professionals from across the U.S. and 27 foreign countries. More than 24,000 future health professionals and 21,000 community members have benefited from institute courses or programs.
Since inception, the institute has provided online training to:
- 1,753 nurses;
- 932 social workers;
- 1,703 chaplains;
- 224 physicians;
- 2,891 multidisciplinary professionals;
- 1,769 specialty areas; and
- 2,833 Care Management/Care Excellence trainees.
Key Takeaways
By revisiting Archstone Foundation’s investment in the CSU Shiley Institute for Palliative Care, we discovered several important lessons and key takeaways:
- Online Access. To meet the vision of a future where access to palliative care is readily available, the institute pioneered a dynamic, interactive online educational model that has made an industry-wide impact by expanding the professional community of care providers who can receive training in palliative care. Courses are designed for completion through self-paced, independent study, with certain courses conducted in cohorts that gather peers from a professional discipline facilitated by an expert instructor. The cohort courses are comprehensive, spanning weeks or months, and confer specialty certificates on completion. All courses confer continuing education credits in a variety of disciplines.
- Customizable and Organization-Specific Courses. The institute also offers organizations the option to create custom courses for their professional staff. For example, the institute created a self-paced course specifically for Kaiser Permanente entitled, “Specialty Palliative Care Essentials.” This transdisciplinary course is still in use by Kaiser today and has been both effective and profitable. To date, 706 Kaiser employees have completed the course, with more currently in process. Kaiser subsidized the course development and pays a reduced fee per enrollment.
- Setting and Revisiting Target Outcomes. Although the project came close to meeting the original goals for chaplains and social workers, reaching enrollment targets for physicians was more challenging. Courses were originally intended to reach the interdisciplinary team, and once the Medicare rules changed in 2016 to allow physicians to bill for Advance Care Planning (Codes 99497 and 99498), the institute began to see an uptick in physician enrollment. Physician-specific courses were added in 2018, along with Continuing Medical Education Accreditation from the American Medical Association Physician Recognition Award (AMA PRA) and the American Academy of Family Physicians (AAFP). The institute is currently in talks with health systems to develop a contract for using the physician training. Also, in development for launch in late 2020, is a certificate program for physician assistants.
- Earned Income. In 2018-19, the year after the Archstone Foundation grant ended, the CSU Shiley Institute for Palliative Care’s budget was $1.2 million, or 75 percent of its prior, grant-funded year. In 2019-20, the institute is on track to match that revenue, despite significant COVID-19-related drop offs in paid enrollments this spring. Earned income—that is, income earned from course fees—will comprise 42 percent of total revenue this year. The project has a diversified income base and is well on its way to being a sustainable enterprise.
- Updates and Continued Content Development. New course offerings for 2019-20 include: the Foundational Series for Hospital Care Managers, Advanced Concepts Series for Hospital Care Managers, Leadership Series for Hospital Care Managers, Pediatric Palliative Care Multidisciplinary and Clinical Certificate Programs (designed for physicians, nurse practitioners, physician assistants, Advanced Practice Registered Nurses, registered nurses, and other clinicians). A new offering this spring, rapidly developed in response to the COVID crisis, is a “master class” in Telemedicine for Palliative Care, utilizing the same online interactive platform used for provider-patient visits. The Shiley gift also includes funds to revise and keep existing curriculum up to date, and contracts with Kaiser and other health systems provide more opportunities to update content.
- Leveraged Funding. The Archstone Foundation funding assisted the CSU Shiley Institute for Palliative Care in successfully obtaining additional funds from community philanthropist and donor Darlene Shiley, California HealthCare Foundation, UniHealth Foundation, and the San Diego Hospice Foundation. In total, Darlene Shiley has donated $6 million to CSUSM, the majority of which has been in support of the institute.
The institute has continued to provide training to palliative care professionals, while growing its earned revenue. The first years were focused on developing course content and recruiting students, and now they are looking to take the program to scale. The CSU Shiley Institute for Palliative Care has indeed become a national resource for palliative care training while creating diversified earned revenue streams to continue its mission into the future.
