What Is the California State University Institute for Palliative Care?

Jennifer Ballentine is the Executive Director of the California State University Institute for Palliative Care. The Institute primarily teaches healthcare professionals about palliative care and the nuances of the field. The main Institute is hosted by CSU San Marcos, with campus partners at San Marcos, CSU Fresno and CSU Monterey Bay. The Institute is also in active outreach with several other campuses around the state.

Editor’s note: This interview has been edited for length and readability. 

Lucas Morgan: Hello Jennifer! Thank you so much for taking the time to speak with me. What are your educational and professional backgrounds and how did you initially become involved with palliative care?

Jennifer Ballentine: I came into this work as a second journey after a long and successful career as a book production entrepreneur. I can’t remember exactly how it came about, but someone told me it would be interesting to volunteer at a hospice. I did that, got very interested in it, and enrolled in a Master’s program at Regis University.

I was involved in a lot of volunteer committees, coalitions, etc. around the time I was finishing that program. Eventually an opportunity came along that allowed me to become director of programs at the state-wide Colorado Hospice Organization.

Lucas: Can you describe the CSU Institute for Palliative Care and its mission?

Jennifer: It is a state-wide institute of the California State University (CSU) system. It’s partially supported by the CSU system, however, we are responsible for the budget. So our funding comes in part from foundations as well as revenues from course registration fees.

Our courses are all entirely online and are directed towards current healthcare professionals who are looking to get into palliative care or increase their palliative care skills. We enroll individuals who are interested, and we also work with organizations who are interested in using our curriculum and online platform for their own in-house training, on-boarding and up-leveling for their workers. We are a workforce development initiative of the Cal State system. Additionally, we have partners from other CSU campuses who are working to integrate our content into both undergraduate and graduate program curricula so that new workers coming into the workforce will know about palliative care.

The CSU system graduates about 85 percent of the California-state healthcare workforce, which equates to roughly 15 to 20 percent of the national healthcare workforce. It’s an important pipeline into the field.

Lucas: How long have you worked at the CSU Institute for Palliative Care?

Jennifer: A little over a year. I started at the end of September 2017.

Lucas: What exactly is your role at the Institute?

Jennifer: I’m the executive director so it’s comparable to an executive director at a non-profit organization. I’m responsible for setting the direction and managing the team of directors who then manage the staff. I’m heavily involved in fundraising. I’ve got my fingers in every possible pie, as they say.

Lucas: How would you describe palliative care to someone who knows nothing about the practice?

Jennifer: Palliative care is a medical specialty that is focused on improving quality of life, relieving pain symptoms and stress and providing an extra layer of support for patients, their families and their caregivers. It’s available to anyone at any age, at any stage of illness, without having to forego curative treatment. You don’t have to be at end of life, and you don’t have to give up on chemotherapy or radiation or whatever else you’re pursuing. Palliative care really focuses on making sure a patient is comfortable and supported and their symptoms are well managed.

Credit: cheyenneregional.org

Lucas: Who provides palliative care?

Jennifer: It’s provided in a lot of different settings. This is one confusing aspect about palliative care. It can look very different depending on where you are. The most prevalent form of palliative care is provided in the in-patient hospital setting. In this hospital setting, a patient could be in the advanced stages of their illness. The question then arises, “What treatment plan do we pursue at this point to support your goals?”

Then the palliative care team is brought in to help the patient understand what both their medical and personal goals are. The team then works with the patient’s other doctors to create a treatment plan that is going to meet the patient’s goals. You may not think you need an entirely different palliative care team, but you do. It’s an interdisciplinary approach so there’s a physician, nurse, social worker and a chaplain, all of whom bring a different lens to the conversation to really support the individual. This kind of care is very episodic, it happens once and there isn’t a lot of follow up.

Lucas: How about other “forms” of palliative care?

Jennifer: There are different kinds of clinics and hospice organizations that offer out-patient or community-based palliative care. In these cases the patient is seen either at home or in the clinic over time to make sure their goals are being met, their symptoms are controlled and they and their family are being supported. Palliative care in this setting is an ongoing complement to whatever other kind of treatment they are getting.

Lucas: What is the technique known as “motivational interviewing” in the realm of palliative care?

Jennifer: Motivational interviewing is a technique used by people who are trying to help patients do better for themselves. Whether it has to do with diabetes or weight management, coping with a serious illness, etc., motivational interviewing helps activate the patient in taking more responsibility and being more in charge with their own health. It’s a specific technique of questions and answers; it’s kind of a Socratic interview method.

Take the example of weight management. One technique is not going to work for every person who wants to lose or manage their weight. One person may need to be sort of scolded into it, another may need to be encouraged into it and yet another may just need the tools to be able to do it themselves. Motivational interviewing is a way to connect with the patient to determine ways that will be most compelling for them to make whatever changes they need.

Lucas: Can non-health care professionals take courses at the CSU Institute for Palliative Care?

Jennifer: A well-informed lay person could take one of our courses, however the courses are designed for working clinicians. The coursework and materials mostly assume a general healthcare background. We do have a series of courses directed to primary care providers and people not too familiar with palliative care who want to learn a baseline set of skills and concepts. There is a series of courses called, “What Every [Blank] Needs To Know About Palliative Care.”

If a lay person just wanted to know about palliative care, the “What Every Healthcare Professional Needs To Know About Palliative Care” course would be a great entry point just to get a sense of it all.

Check back next week when we continue our conversation with Jennifer Ballentine about the CSU Institute for Palliative Care and its role in education and outreach related to palliative care.