Hospice and Palliative Medicine Fellowship

CMC is the flagship hospital of Atrium Health and the largest hospital in the region. CMC serves as the region’s only Level 1 trauma center and is an approved transplant center for heart, kidney, pancreas and liver. With Wake Forest University School of Medicine serving as the academic core of the Atrium Health enterprise, CMC also serves as one of North Carolina’s 5 Academic Medical Center Teaching Hospitals. The Wake Forest School of Medicine in Charlotte is slated to open in Fall 2025.

The Department of Supportive Oncology is chaired by Dr. Declan Walsh, Hemby Family Endowed Chair and palliative medicine pioneer and visionary. DSO includes the Sections of: Oncology Palliative Medicine, Integrative Oncology, Cancer Rehabilitation, Oncology Nutrition, Psycho-Oncology, Cancer Navigation, Cancer Survivorship, Senior Oncology, Research and Education.

The DSO research strategy centers around four thematic areas: Cancer Pain and Opioids, Malnutrition and Inflammation, Psycho-Oncology and Cancer Related Fatigue. Each area has a research taskforce, which is comprised of subject matter experts from the Department, Levine Cancer Institute, Atrium Health and strategic partners within the community. The purpose of each taskforce is to establish partnerships and develop research projects.

The inpatient team has 10,000 new consults per year across 9 Atrium Health hospitals, and over 2,000 at the main hospital, seeing oncology, non-oncology, ICU (CCU, NSICU, Trauma, MICU) and non-ICU patients.

LCI provides cutting-edge cancer care in a community, academic hybrid setting with 25+ locations throughout the region with strong referral streams in a large tertiary referral center and over 17,000 new patients per year. LCI’s academic and research headquarters and DSO reside on the CMC campus. The outpatient palliative medicine clinic has 5 regional locations with over 700 consults per year.

The Multispecialty Palliative Medicine Clinic focuses on providing interdisciplinary care to patients with serious medical and oncological illnesses. Caring for patients with heart, liver and kidney disease, including peri-(solid organ) transplant and peri-LVAD care, is the clinic’s primary focus.

Levine Children’s Hospital is the largest comprehensive children’s hospital geographically located between Atlanta and Washington, DC, and treats more pediatric patients per day than any other hospital in North Carolina. LCH is the region’s only pediatric transplant program for heart, kidney, liver and blood and bone marrow transplant, and it is the only pediatric CVICU dedicated to caring for children with heart conditions, with the region’s only ECMO capabilities. LCH also features the region’s first 24/7 emergency room for children, staffed by providers trained in pediatric emergency medicine.

The PACT (Pediatric Advanced Care Team) at LCH is a dynamic, multidisciplinary inpatient consult service, providing symptom management, family support, advance care planning and bereavement services to seriously ill children and their families. The team consists of 2 providers, an advance practice provider, social worker and registered nurse coordinator.

Hospice of Union and Anson Counties, led by a medical director, provides care at home and at the McWhorter Inpatient Unit, which has a total of 12 beds with 6 for general inpatient.

The team had 4 Center to Advance Palliative Care (CAPC) abstract recognitions in 2021. The hospice service line and community-based palliative care is led by Medical Director, Bridget Earle, MD, HMDC, FAAHPM, who was accepted to the American Hospital Association Women’s Equity and Leadership (WEL) Scholars Program for 2021-2022.

In response to the COVID-19 pandemic, the palliative care and hospice team converted to a virtual platform to perform/maintain palliative and hospice visits. The team initiated automatic palliative consultations and weekly palliative coverage for COVID-19 designated Skilled Nursing Facility (SNF).

Hospice & Palliative Care of Cabarrus County, also led by a medical director, provides care at home and at Tucker House, which has a total of 24 beds with 14 for general inpatient. 3 MD and 6 APP hospice practitioners serve a combined daily census of approximately 300 patients.

Care transformation projects initiated a high acuity workgroup and created new policies for palliative sedation, non-invasive ventilation and LVAD removal. An acuity triage document was created for SNF palliative consultations, and a new and improved hospice heart failure program launched.

New initiatives to revise IV Lasix protocol align with Atrium Health Sanger Heart and Vascular Institute to decrease heart failure length of stay. The Charleston Co-morbidity Index (CCI) increased palliative and hospice consultations and follow-ups were initiated for post-acute palliative care SNF consults.

Part of Atrium Health, Sardis Oaks nursing home provides skilled nursing and rehabilitative services for short-term, long-term and end-of-life care.

The Sharon (formerly known as Sharon Towers) is a continuing care retirement community offering independent living, assisted living and skilled nursing care for older adults. It was founded in the late 1960s by Presbyterian leaders in Charlotte. The not-for-profit community is home to over 300 residents on a 28-acre campus in the SouthPark area of Charlotte. The geriatric medicine fellow provides primary geriatric care in an outpatient clinic on the Sharon Towers campus in addition to providing medical services to patients in assisted living and skilled nursing facilities.