Our Passion

Our Passion:

Hui Pohala is committed to collaboration so that people of Hawaii with serious illness get the right care, at the right time, in the right place

Right Care

Right care is centered on the whole person, not just their disease. Right care improves quality of life.

Right Place

Right place means services also occur in the home and community, not just in the hospital or clinic.

Right Time

Right time means access to care is provided whenever help is needed, 24/7, by a provider who knows the person and honors their wishes.

We advocate for the best lives possible in the face of serious illness.

Guiding Principles

Excellence, Evidence-Based

The principles of excellence and basing decisions and plans on evidence and data will be integrated into all of our work. Any conclusions or recommendations Hui Pohala makes will be based upon the best evidence available.

Continuous Learning

Hui Pohala is committed to learning about and spreading bright spots created by others working to expand palliative care. We will continue to leverage the valuable resources developed by CAPC and others to inform how we engage stakeholders and “Plan Forward.” Hui Pohala’s opportunity will be to discover, learn, and effectively bring that learning to stakeholders who can prioritize and adjust for planning and implementation in Hawai’i.

Collaboration with Stakeholders

Expansion of palliative care requires effective engagement of diverse stakeholders. This requires a robust stakeholder analysis to understand the specific challenges and strategic issues each stakeholder group faces. In addition, skilled communication, excellent facilitative leadership, and effective meeting management are needed. Hui Pohala will inventory what skills we currently possess and which we need to acquire.

Fiscal Sustainability

Hui Pohala will work to develop the infrastructure needed to drive large-scale statewide change. Although much of the infrastructure for the national diffusion of innovation of palliative care has been funded by philanthropy, Hui Pohala understands that donations and grant funding are not a sustainable strategy for funding ongoing and long term work. On the other hand, capital sources are essential in a startup to develop, among other things, an effective data strategy which demonstrates the need, tracks progress, and builds buy-in from stakeholders. Hui Pohala is investigating various strategies for funding the components of the first three year phase of this work.

Strategies to Accomplish the Mission

To serve as a catalyst and convener to improve access to high quality palliative care.

1. Build a winning team

Determine skills and credibility needed to drive improvement
Design and implement processes for continuous improvement
Assure that there are clear and engaging measures of success

2. Develop resources needed to accomplish mission

Develop 501(c)3 vehicle through fiscal sponsorship
Identify essential information and resources needed for start up funding
Identify additional partners who could help to sustain the work

3. Strategic learning and planning

Research and summarize what has worked elsewhere to expand access to high-quality palliative care, especially in the community and home setting
Identify important gaps in data, knowledge, existing plans to expand access to high-quality palliative care, additional barriers, and key strategic questions to be addressed by stakeholders
Obtain needed data
Develop an approach to engaging stakeholders to address these issues

4. Engage essential stakeholders to drive improvement

Conduct a stakeholder analysis
Engage stakeholders to reduce barriers to access to high quality palliative care in four key domains identified by CAPC and by the Hawaii Palliative Care Summit:
- Support growth of the palliative care workforce, grow clinical skills needed, and strengthen links between primary palliative care and specialty palliative care.
- Support sustainable financing of high quality palliative care
- Facilitate development of common measures of access, value, quality, and patient/caregiver satisfaction
- Grow public and clinician awareness of the value of palliative care

5. Support MedQuest’s efforts to develop a palliative care benefit

Host a stakeholder meeting in 2021 for Medquest to present its proposed palliative care benefit/target patient population and gather stakeholder input

6. Build strong communication externally and internally

Work to reduce key barriers to high quality palliative care

Hui Pohala will catalyze systems change by organizing work teams to understand stakeholder perspectives and engage stakeholders in four key areas identified by CAPC and by the Hawai’i Palliative Care Summit in 2020 as essential to reducing barriers and expanding access to palliative care. These teams will focus on:

Expanding and strengthening the palliative care workforce
Growing public and clinician awareness of the value of palliative care
Facilitating the development of a common model, standards, and measures for palliative care of seriously ill patients
Supporting models of sustainable financing of palliative care

Preliminary plan for work teams to reduce barriers to access:

Expanding and strengthening the palliative care workforce

Promoting palliative care skills via online or in-person training for all types of providers including physicians, nurses, social workers, and chaplains
Leveraging/expanding existing curriculums in Hawaii professional schools
Strengthening links between specialty palliative care and primary care providers

Growing awareness of the value of palliative care for providers

Working with medical and specialty societies to share information
Engaging primary care providers and specialists around the benefits of palliative care for their patients with serious illness
Popularizing stories which reflect improved quality of life and satisfaction of patients/families who received palliative care and the providers who referred them

Growing public awareness of the value of palliative care for people, families, caregivers

Reviewing CAPC research on messaging, then promoting clear and simple messages, identifying and using secondary messages for more precise focus on target audience
Customizing communication materials for specific communities
Maximizing regional networks for community outreach
Developing materials to inform policy makers

Facilitating the development of a common model, standards, and measures for palliative care of seriously ill patients

Review, summarize, and share relevant literature and “model” programs
Facilitate stakeholder dialogue to reach consensus on the essential palliative care standards including required roles, services, and functions
Facilitate stakeholder dialogue to reach consensus on key measures of access, quality, value and outcomes

Developing sustainable financing of palliative care

Addressing current misalignment of insurance payments
Demonstrating the business case for palliative care
Supporting organizational capacity to provide high quality home- based palliative care.

Summary of findings from April 2020 Hawaii Palliative Care Summit

The diverse participants who attended the palliative care Summit on April 25, 2020 strongly agreed on the pressing need to expand access to palliative care services throughout the state of Hawai‘i.

Summary of Findings

The April 2020 Palliative Care Summit was sponsored by the Hawai‘i State Department of Health, the University of Hawai‘i John A. Burns School of Medicine, (UH JABSOM), and Kōkua Mau, a statewide network to improve care for those with serious illness. The 121 participants came from 41 organizations including health plans, health systems, hospices, higher education, state and county government, and nonprofits (including AARP and American Cancer Society). Participants came from all counties and included doctors, nurses, social workers, chaplains, community advocates and administrators.

The summit provided an overview of the current state of palliative care in Hawai‘i including descriptions of palliative care programs currently serving people living in the islands with serious illness. Program leaders shared evidence of improved patient and family experience of care, and improved pain and symptom management. Reduced hospital, ER, and acute care utilization due to high quality palliative care was responsible for significant cost savings. The summit concluded with a nearly universal call to action to expand access to palliative care statewide by reducing the current identified barriers:

Inadequate payment mechanisms
Lack of agreed upon standards of care and absence of consistently applied quality/value metrics
Shortage of skilled palliative care providers
Lack of a broadly understood definition of palliative care
Lack of awareness of the public as well as persistent provider misperceptions about palliative care

Summit Follow up

Summit organizers heard the loud call to action to improve access to palliative care statewide. Following the Summit, organizers formed a palliative care Leadership Group, supported by a skilled project manager to grow the infrastructure necessary to drive major improvements. The Leadership Group concluded that substantially improving access will best be accomplished through building a strong statewide collaboration “all paddling in the same direction”. This collaborative effort is working to engage stakeholders to reduce barriers through four work teams. Also identified was an important opportunity to support Med-Quest’s ambition to develop a federally supported palliative care benefit. The Leadership Group decided that to optimize our chances of success, an additional organizational structure was needed and Hui Pohala was formed. Hui Pohala is an unincorporated association including JABSOM, Chaminade University School of Nursing and Healthcare Professionals, Queen’s Community & Post-Acute Care Services, and Kokua Mau, which also functions as the Hui Pohala fiscal sponsor.

Hui Pohala will host the upcoming Palliative Care Summit on Med-QUEST Palliative Care Benefit Design to be held on June 26, 2021. Med-QUEST will present its proposed draft palliative care benefit and solicit input from diverse stakeholders as part of its effort to obtain a CMS waiver to establish the benefit. Stakeholders who want to give input or work with the work teams are asked to please contact Crystal Costa, ccosta@huipohala.org or Rae Seitz, rseitz@huipohala.org.

For full Summit report: Report from the Hawai’i Palliative Care Summit – April 25, 2020

For more details of summit presentations: Palliative Care Summit 2020 – Kokua Mau

Coming later:

History of palliative care in Hawaii
Palliative Care 101
Why Hawaii is well-positioned to expand access to palliative care
Additional barriers to be addressed
Potential Measures of Access