Complex Chronic Illness in Palliative Care: Adult Case Study Involving the Interdisciplinary Team (P2)

Nursing assessment comprising physical, psychosocial, and spiritual domains is essential for planning palliative care. Such assessment involves input from the patient, family, and all members of the interdisciplinary team, with information shared verbally as well as in the patient’s health records. Ongoing, detailed, and comprehensive assessment is requisite to identifying the complex and changing needs and goals of patients facing chronic or life-threatening illness and those of their families. In this chapter, goals, techniques, and tools are discussed for assessing patients and families during four timeframes occurring during chronic and life-threatening illnesses: diagnosis, during treatments, when treatment is over, and during active dying. A case study threads through the chapter to illustrate the application of these principles and techniques in culturally appropriate ways.

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The Chaplain as the Mediator Between the Patient and the Interdisciplinary Team in Ethical Decision Making: A Chaplaincy Case Study Involving a Quadriplegic Patient

Health and Social Care Chaplaincy ◽

10.1558/hscc.34301 ◽

2017 ◽

Vol 5 (2) ◽

pp. 241-256

Author(s):

Jeffery N. Murphy

Keyword(s):

Decision Making ◽

Ethical Decision ◽

Ethical Decision Making ◽

Interdisciplinary Team

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A new model for understanding the role of environmental factors in the origins of chronic illness: a case study of type 1 diabetes mellitus

Medical Hypotheses ◽

10.1016/j.mehy.2004.04.014 ◽

2004 ◽

Vol 63 (6) ◽

pp. 1035-1046 ◽

Cited By ~ 6

Author(s):

Veronique P. Mead

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Chronic Illness ◽

Environmental Factors ◽

Type 1 Diabetes Mellitus ◽

New Model

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Educational Digital Case Studies: Enhancing Palliative Care Communication and Interdisciplinary Team Interaction in the Hospital Setting (FR431-D)

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2013.12.107 ◽

2014 ◽

Vol 47 (2) ◽

pp. 437-438

Author(s):

Randi Diamond ◽

Michele Greene ◽

Ronald Adelman ◽

Dory Hottensen ◽

Lucy Bruell ◽

...

Keyword(s):

Palliative Care ◽

Case Studies ◽

Hospital Setting ◽

Interdisciplinary Team ◽

Team Interaction

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Analysis of Palliative Care Process through SAP-LAP Inquiry: Case Study on Palliative Care and Training Centre

Global Journal of Flexible Systems Management ◽

10.1007/s40171-016-0137-1 ◽

2016 ◽

Vol 17 (4) ◽

pp. 403-416 ◽

Cited By ~ 4

Author(s):

Venkatesh Iyengar ◽

Abhishek Behl ◽

Samaya Pillai ◽

Bhausaheb Londhe

Keyword(s):

Palliative Care ◽

Care Process ◽

Training Centre ◽

And Training

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Health system characteristics of quality care delivery: A comparative case study examination of palliative care for cancer patients in four regions in Ontario, Canada

Palliative Medicine ◽

10.1177/0269216311416697 ◽

2011 ◽

Vol 26 (4) ◽

pp. 322-335 ◽

Cited By ~ 17

Author(s):

Jonathan Sussman ◽

Lisa Barbera ◽

Daryl Bainbridge ◽

Doris Howell ◽

Jinghao Yang ◽

...

Keyword(s):

Palliative Care ◽

Health System ◽

Acute Care ◽

Pattern Analysis ◽

Care Delivery ◽

Quality Care ◽

Structural Features ◽

Comparative Case Study ◽

Care Utilization

Background: A number of palliative care delivery models have been proposed to address the structural and process gaps in this care. However, the specific elements required to form competent systems are often vaguely described. Aim: The purpose of this study was to explore whether a set of modifiable health system factors could be identified that are associated with population palliative care outcomes, including less acute care use and more home deaths. Design: A comparative case study evaluation was conducted of ‘palliative care’ in four health regions in Ontario, Canada. Regions were selected as exemplars of high and low acute care utilization patterns, representing both urban and rural settings. A theory-based approach to data collection was taken using the System Competency Model, comprised of structural features known to be essential indicators of palliative care system performance. Key informants in each region completed study instruments. Data were summarized using qualitative techniques and an exploratory factor pattern analysis was completed. Results: 43 participants (10+ from each region) were recruited, representing clinical and administrative perspectives. Pattern analysis revealed six factors that discriminated between regions: overall palliative care planning and needs assessment; a common chart; standardized patient assessments; 24/7 palliative care team access; advanced practice nursing presence; and designated roles for the provision of palliative care services. Conclusions: The four palliative care regional ‘systems’ examined using our model were found to be in different stages of development. This research further informs health system planners on important features to incorporate into evolving palliative care systems.

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