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    Program Contact

    Dr. Lianne Hirano
    Program Director

    Dr. David Gruenewald 

    Dr. Paula McPoland
    Associate Program Director
    Pediatric Palliative Fellowship Track

    Jeanine Hughes
    Program Administrator

    Fellowship curriculum

    Our 12-month clinical curriculum includes:

    • 6.5 months of inpatient adult consultation service (at 4 separate hospitals)
    • 2.5 months of home hospice 
    • 1 month of long-term care / inpatient hospice
    • A half month of inpatient pediatric consultation service
    • 1.5 month of electives and scholarly time
      • One month of ethics
      • Inpatient pain service
      • Chronic pain clinic

    Fellowship Clinical Training Sites

    Fellows rotate through four affiliated University of Washington Hospitals. UW Medicine hospitals and programs consistently rank highly in U.S. News and World Report’s annual “Best Hospitals” issues.

    Harborview Medical Center

    HMC is a is a 413-bed hospital owned by King County and managed by the University of Washington. Harborview is a world-renowned Level 1 adult and pediatric trauma center. HMC Palliative Care Consultation Service (PCCS) sees patients referred from inpatient services, helping patients, family and primary care teams with care planning and symptom management. Fellows will be part of PCCS teams, which include division faculty. Patients are also referred to the outpatient clinic.


    Fred Hutchinson Cancer Center - Palliative Care Clinic

    The outpatient Palliative Care clinic at the Fred Hutchinson Cancer Center (FHCC) is a consultation service. FHCC, University of Washington Medicine, and Seattle Children’s form the only NCI-designated comprehensive cancer center in Washington State.

    Our service consists of a medical and administrative director, program coordinator, 3 nurse practitioners, 2 nurses, chaplains, social workers, child-life specialist, nutritionist, and other representatives of FHCC supportive services. Any clinician can refer patients to our service. Patients can also self-refer. The vast majority of our referrals are for pain and symptom management. Preceptors are ACHPN- certified ARNPs. Fellows are assigned to clinic once every other week.


    Seattle Children's Hospital

    Seattle Children's Hospital serves as the pediatric and adolescent academic medical referral center for the largest landmass of any children's hospital in the country (Washington, Alaska, Montana and Idaho). For more than 100 years, Children's has been delivering superior patient care and advancing new treatments through pediatric research. U.S. News & World Report magazine has ranked Seattle Children's Hospital among the nation's top children's hospitals for 18 consecutive years. In 2010, Children's was ranked seventh in the country for pediatric cancer care. Seattle Children's is a 250-bed children's general facility. Last year Seattle Children's had 13,482 admissions and performed 5,190 inpatient and 6,960 outpatient surgeries, and saw 37,508 emergency room visits. Children's serves as the primary teaching and clinical and site for the Pediatric Track fellow.


    University of Washington Medical Center

    The UWMC PCCS sees patients referred from the inpatient services, aids patient, family and care teams with goal setting and care directives, assesses patient appropriateness for and interest in hospice care, advises the primary care team on symptom management and care planning, provides information and emotional support to patients and families, and facilitates discharge planning to community hospices and other agencies.

    PCCS teams follow patients from initial referral until death or discharge to community-based services. Core PCCS team members include social workers, chaplains and trainees; medical students, residents, fellows, working closely with primary providers. Other services such as pharmacy, pain service, psychiatry, speech, physical and occupational therapy are available as needed. PCCS teams meets bi-weekly to review service goals and particular patients.


    VA Puget Sound Health Care System

    The VA Puget Sound Health Care System Palliative Care and Hospice Service (PCHS) provides a full range of consultative services addressing patients' physical, psychological, social, and spiritual needs. PCHS advises primary care teams on symptom management, goal setting, discussion of code status, communication issues, decision-making, management of spiritual and existential distress, disposition issues, management of psychosocial issues, and care in the last hours of life.

    PCHS provides information and emotional support to patients and their families, assesses patients’ appropriateness for and interest in hospice care, and facilitates discharge planning and referrals to community hospice programs. Consultative support is provided for veterans receiving inpatient end of life care in the Community Living Center (CLC) 10 hospice beds. The PCHS team includes physicians, nurses, care coordinators, nurse practitioners, social workers, psychologists, chaplains, and administrative support personnel.

    Other professionals including pharmacists, psychiatrists, dietitians and physical therapists. Occupational and recreation therapists are available by consultation. The PCHS team meets weekly in Inter-Disciplinary Team format to review all active patients on the service, as well as to debrief recently deceased patients.


    Affiliated Training Sites

    Franciscan Hospice House

    Franciscan Hospice House is a free standing 20 bed inpatient unit. The unit admits patients meeting General Inpatient (GIP) level criteria for complex pain and symptom management. Average daily census is 15 patients and average length of stay is 6 days.


    Providence Hospice of Seattle

    Providence Hospice has 6 Interdisciplinary Teams (IDT). Hospice clients are discussed every other week regarding clinical and psychosocial condition. Fellows learn the dynamics of IDT, the function of members, and provide direct input as a team member in the role of Medical Director and hospice physician.