Initiating XXXX and palliative care outpatient services for the suburban underserved in Montgomery County, Maryland: Lessons learned at the NIH Clinical Center and MobileMed.

@entity1 @entity1118 @entity158
OBJECTIVE: With the ongoing expansion of palliative care services throughout the United States, meeting the needs of socioeconomically marginalized populations, as in all domains of healthcare, continues to be a challenge. Our specific aim here was to help meet some of these needs through expanding delivery of @entity158 and palliative care services by establishing a new clinic for underserved @entity1 and collecting descriptive data about its operation. METHOD: In November of 2014, the National Institutes of Health Clinical Center's @entity158 and Palliative Care Service (PPCS) launched a bimonthly offsite @entity158 and palliative care outpatient clinic in collaboration with Mobile Medical Care Inc. (MobileMed), a private not-for-profit primary care provider in Montgomery County, Maryland, serving underserved area residents since 1968. Staffed by NIH hospice and palliative medicine clinical fellows and faculty, the clinic provides specialty @entity158 and palliative care consultation services to @entity1 referred by their primary care healthcare providers. A @entity1 log was maintained, charts reviewed, and referring providers surveyed on their satisfaction with the service. RESULTS: The clinic had 27 @entity1 encounters with 10 @entity1 (6 males, 4 females, aged 23-67) during its first 7 months of operation. The reason for referral for all but one @entity1 was @entity1118 of multiple etiologies. @entity1 had numerous psychosocial stressors and comorbidities. All primary care providers who returned surveys (n = 4) rated their level of satisfaction with the consultation service as "very satisfied" or "extremely satisfied." SIGNIFICANCE OF RESULTS: This brief descriptive report outlines the steps taken and logistical issues addressed to launch and continue the clinic, the characteristics of @entity1 treated, and the results of quality-improvement projects. Lessons learned are highlighted and future directions suggested for the clinic and others that may come along like it.
