Texas A&M Distinguished Professor Offers Healthcare Solutions

Professor Leonard Berry suggests changes to end-of-life care.

By Grant Vassar, Texas A&M University Mays Business School

Several research projects by University Distinguished Professor of Marketing Leonard Berry at Mays Business School have come to fruition.

Berry, whose research focuses on improving service in cancer care, has been involved with multiple studies on improving the quality of end-of-life care for patients with advanced illness.

Unlocking intrinsic hope in patients with advanced illness

Can cancer patients tap into a certain kind of hope that is often overlooked but incredibly therapeutic and healing?

In an article published in The BMJ Opinion (British Medical Journal) titled “The Dual Nature of Hope at the End of Life,” Berry and his co-authors suggest clinicians can help patients tap into a certain kind of hope that is often overlooked but incredibly therapeutic and healing. They differentiate between two types of hope: focused (focused on a cure and recovery) and intrinsic (peace with circumstances and ability to live in the moment).

They suggest that intrinsic hope can be unlocked in several ways:

  • Compassionately telling patients the truth about their prognosis;
  • Managing their pain;
  • Conveying partnership and non-abandonment

His co-authors for the study were Dr. Brad Stuart, chief medical officer at the Coalition to Transform Advanced Care in Washington, D.C., and Avis Begoun, a clinical psychologist based in Palo Alto, Calif.

Patients should have more choices in end-of-life care

End-of-life care for patients with advanced illness is not only emotionally taxing for all involved, but also costly. Conventional models discourage timely use of hospice services. Often this occurs only after a series of aggressive and expensive ICU visits, at the end of which hospice is called for the final few days or hours of a patient’s life.

But Berry and his co-authors suggest there is a way to help to both ensure patients’ quality of life and minimize costs: options.

In an article published in the Harvard Business Review, “Giving Seriously Ill Patients More Choices About Their Care,” Berry and his co-authors envision a better model for advanced illness management that empowers patients to make choices early on, especially to choose to focus on improving the quality of their life, rather than prolonging it.

The authors’ model for advanced illness management focuses on team-based home care and contains several key components, including the ability to:

  • Help patients clarify their care preferences and identify their priorities;
  • Assist patients in articulating these preferences to healthcare providers;
  • Establish personal relationships among patients, family members and staff;
  • Ensure seamless communication across all clinical settings;
  • Relieve pain and suffering;
  • Provide support to families

His co-author for the article was Dr. Brad Stuart, chief medical officer at the Coalition to Transform Advanced Care in Washington, D.C.

Practical ways to improve hospice care

In the U.S., the market for hospice care is growing rapidly. Unfortunately, the quality of hospice care is prone to vary, and many institutions deliver suboptimal service. Low-quality hospice care is often blamed on the growing market share of for-profit hospices.

Berry contends that poor service quality is a function of poor organizational leadership.

In an article published in the May 2017 issue of Journal of Palliative Medicine (2017) titled “Practical Ideas for Improving the Quality of Hospice Care,” Berry and co-authors propose multiple ways to reform hospice organizations, including:

  • Refining standards of care and developing more targeting methods of enforcement
  • Strengthening hospice oversight by state health agencies
  • Creating more fairness in the patient mix
  • Encouraging more frequent visits by hospice staff
  • Incorporating hospice volunteers
  • Increasing referrals to bereavement programs
  • Improving human resources that serve clinical care

His co-authors for the article were Stephen Connor, executive director at the Worldwide Hospice Palliative Care Alliance in Fairfax Station, Va., and Dr. Brad Stuart, chief medical officer at the Coalition to Transform Advanced Care in Washington, D.C.

Through a child’s eyes

Berry also contributed to a project in which the mother of a 4-year-old boy relayed his story in a paper titled “How a child with cancer moved from vulnerability to resilience,” published June 23, 2017 in Journal of Clinical Oncology.

###

This story by Grant Vassar originally appeared in Mays Impacts


More: Business, Law, & Society

Follow Texas A&M

, , ,