The University of Utah College of Nursing (CON) was awarded a $250,000 Cambia Health Foundation grant to develop a new fellowship program, Advanced Practice Clinician Palliative Care Fellowship: A Leading-Edge Program Responding to Workforce Demands, Underserved Populations, and Rural and Behavioral Health Needs.
Lynn Reinke, PhD, APRN, FAAN, Claire Dumke Ryberg, RN, Presidential Endowed Chair in End-of-Life/Palliative Care at the CON, and Holli Martinez, FNP-BC, ACHPN, FPCN, Program Director of the Supportive and Palliative Care Program at the University of Utah Hospital and Huntsman Cancer Institute will co-lead the project.
“At Cambia Health Foundation, we are committed to advancing equity through whole-person health, and we can’t do that without also supporting the health care workforce,” said Peggy Maguire, president of Cambia Health Foundation. “I’ve often said that palliative care is the type of whole-person care that should be expected throughout everyone’s journey with the health care system. Unfortunately, behavioral health access remains a pressing community need, particularly for those who have historically been underserved and marginalized. We’re honored to support University of Utah College of Nursing’s innovative fellowship program which will result in the first and only Interprofessional Fellowship training program in the western United States.”
The three-year grant will allow Reinke, Martinez, and collaborators to develop a twelve-month Advanced Practice Clinician (APC) Palliative Care Fellowship, which will support three fellows over the course of the grant at the CON beginning in July 2023. This will be the first fellowship of its kind in the west.
Fellowships will be offered to board-certified Doctor of Nursing Practice or Master of Science-prepared nurse practitioners with one to two years of work experience and an interest in palliative care. The program will offer two tracks to meet the unique needs of Utahns: a specialty for behavioral health interventions, and a specialty focusing on citizens living in rural communities with little access to basic medical needs.
“The goal of the project is to build and strengthen the workforce of highly skilled clinicians to deliver whole person and palliative care to patients living with serious illness and their families residing in Utah’s rural and underserved communities,” said Reinke.
“With the proliferation of palliative care teams in Utah and across the nation, we have a responsibility in caring for people with serious illness by training and educating providers in this critical specialty,” Martinez added.
Utah’s population is changing—health care providers and systems should be prepared to meet the evolving needs of its communities. The state is becoming more ethnically diverse, requiring clinicians to learn and maintain skills that equitably address the needs of diverse patients. Utah’s population is also aging. The percentage of Utahns age 65 and older is expected to double over the next fifty years, resulting in a higher prevalence of conditions such as Alzheimer's disease, heart disease, and lung diseases—clinicians need to know how to care for an aging population.
The team is also focusing on the mental health needs and substance abuse disorders of Utahns by incorporating behavioral health training into fellowship curriculum.
“We hope to improve the mental health of persons and families and those residing in rural, underserved areas of Utah,” said Reinke. “Strengthening the workforce by training advanced practice clinicians will increase access to palliative care, foster wellness and prevention, reduce stigma, and increase collaborative care models throughout the state.”
To maintain program sustainability and grow the palliative care workforce, Reinke and team will leverage their ongoing relationships with CON APC alumni, especially those practicing in rural settings. They plan to develop networking and educational opportunities—such as organizing regional conferences and offering continuing education courses—in order to build a practice community.
“Our mission is to create a pipeline of potential APC palliative care fellows to provide high-quality, competent care to any Utahn with serious illness and their families,” said Reinke.
Reinke and Martinez’s work doesn’t end at the APC Palliative Care Fellowship. They plan to build upon the program by offering an interprofessional fellowship wherein physicians, nurse practitioners, physician assistants, and other health care professionals can train together.
“The value of interprofessional education translates into efficient teamwork, positively impacting clinical care, decreasing a patient’s length of stay, and lowering health care cost. Importantly, effective teamwork decreases adverse patient events, improves patient satisfaction of care, and improves job satisfaction,” explains Reinke.
The APC Palliative Care Fellowship is the first step in their multi-phased plan to infuse palliative care into existing curriculum for health care professionals and health care delivery plans across Utah.