Primary palliative care skills | Subspecialty palliative care skills |
Assessment/treatment of physical symptoms |
- Basic pain management
- Basic management of other physical symptoms
- Basic use of adjuvant pain relievers
- Equianalgesic dose conversion
| - Management of refractory pain
- Management of other refractory symptoms
- Methadone transition when large doses of opioids are being used
- Patients with addiction problems and serious illness
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Psychological, social, cultural, and spiritual aspects of care |
- Basic management of depression/anxiety
- Exploration of psychosocial suffering
- Basic exploration of spiritual and religious views
- Basic exploratory family meeting
| - Management of more complex depression, anxiety, grief, and existential distress
- Severe religious/spiritual suffering
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Serious illness communication issues |
- Exploring patient goals in light of circumstances
- Making recommendations about code status
- Seeking consensus among treating professionals
- Seeking consensus among the patient and family
| - Dying patients who want "everything"
- Major conflict among family members
- Major conflict among treating teams
- Requests about assisted dying
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Care coordination |
- Coordinating care among specialists
- Clearly defining the primary treating team
- Managing transitions to hospice care
- Managing transitions out of the hospital
| - Transition to hospice with no clear provider
- Patient/family major resistance to discharge
- Conflict with the designated outpatient provider
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