What are the Challenges for Evaluating a Palliative Care Service?

2005 ◽  
Vol 11 (3) ◽  
pp. 19
Author(s):  
Kate Senior ◽  
David Perkins
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Medical Model ◽  
Palliative Care Service ◽  
Respondent Burden ◽  
Evaluation Approaches ◽  
The Impact

This paper identifies the challenges in researching the impact of a rural palliative care service on its patients, carers and providers in the context of the National Palliative Care Strategy. It describes the use of an anthropological method to overcome problems of acceptability and respondent burden and to enable the elaboration of meaning and valuation by participants. It uses the Griffith Area Palliative Care Service as a case study to illustrate the problems of such research and the value of the anthropological method over more conventional research and evaluation approaches. It makes recommendations about how to assess the outcomes of services such as palliative care where the focus of care is complex, individual and family, and the outcomes go far beyond what can be measured with the medical model.

The impact of a palliative care service on overall hospital mortality in a comprehensive cancer center

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 8034-8034
Author(s):  
A. F. Elsayem ◽  
R. Jenkins ◽  
L. Parmley ◽  
M. L. Smith ◽  
J. L. Palmer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Hospital Mortality ◽  
Care Service ◽  
Palliative Care Service ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
The Impact

The impact of a palliative care service on overall hospital mortality in a comprehensive cancer center

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 8034-8034
Author(s):  
A. F. Elsayem ◽  
R. Jenkins ◽  
L. Parmley ◽  
M. L. Smith ◽  
J. L. Palmer ◽  
...  
Keyword(s):  
Palliative Care ◽  
Hospital Mortality ◽  
Care Service ◽  
Palliative Care Service ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
The Impact

scholarly journals O-22 The impact of a new children’s palliative care service on place of death: giving families choices

2021 ◽  
Author(s):  
Joanna Elverson ◽  
Helen Aspey ◽  
Owen Lever ◽  
Ellie Bond ◽  
Christine Mackerness ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Place Of Death ◽  
The Impact

scholarly journals Opioid errors in inpatient palliative care services: a retrospective review

2018 ◽  
Vol 8 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Nicole Heneka ◽  
Tim Shaw ◽  
Debra Rowett ◽  
Samuel Lapkin ◽  
Jane L Phillips
Keyword(s):  
Palliative Care ◽  
Retrospective Review ◽  
Care Service ◽  
Palliative Care Service ◽  
Direct Result ◽  
Care Services ◽  
Opioid Administration ◽  
Palliative Care Services ◽  
The Impact ◽  
Palliative Patients

Opioids are a high-risk medicine frequently used to manage palliative patients’ cancer-related pain and other symptoms. Despite the high volume of opioid use in inpatient palliative care services, and the potential for patient harm, few studies have focused on opioid errors in this population.ObjectivesTo (i) identify the number of opioid errors reported by inpatient palliative care services, (ii) identify reported opioid error characteristics and (iii) determine the impact of opioid errors on palliative patient outcomes.MethodsA 24-month retrospective review of opioid errors reported in three inpatient palliative care services in one Australian state.ResultsOf the 55 opioid errors identified, 84% reached the patient. Most errors involved morphine (35%) or hydromorphone (29%). Opioid administration errors accounted for 76% of reported opioid errors, largely due to omitted dose (33%) or wrong dose (24%) errors. Patients were more likely to receive a lower dose of opioid than ordered as a direct result of an opioid error (57%), with errors adversely impacting pain and/or symptom management in 42% of patients. Half (53%) of the affected patients required additional treatment and/or care as a direct consequence of the opioid error.ConclusionThis retrospective review has provided valuable insights into the patterns and impact of opioid errors in inpatient palliative care services. Iatrogenic harm related to opioid underdosing errors contributed to palliative patients’ unrelieved pain. Better understanding the factors that contribute to opioid errors and the role of safety culture in the palliative care service context warrants further investigation.

scholarly journals Bereavement support standards and bereavement care pathway for quality palliative care

2017 ◽  
Vol 16 (4) ◽  
pp. 375-387 ◽  
Author(s):  
Peter Hudson ◽  
Chris Hall ◽  
Alison Boughey ◽  
Audrey Roulston
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Care Pathway ◽  
Care Service ◽  
Palliative Care Service ◽  
Bereavement Support ◽  
Care Services ◽  
Palliative Care Services ◽  
Bereavement Care ◽  
The Impact

ABSTRACTObjective:Provision of bereavement support is an essential component of palliative care service delivery. While bereavement support is integral to palliative care, it is typically insufficiently resourced, under-researched, and not systematically applied. Our aim was to develop bereavement standards to assist palliative care services to provide targeted support to family caregivers.Method:We employed a multiple-methods design for our study, which included: (1) a literature review, (2) a survey of palliative care service providers in Australia, (3) interviews with national (Australian) and international experts, (4) key stakeholder workshops, and (5) a modified Delphi-type survey.Results:A total of 10 standards were developed along with a pragmatic care pathway to assist palliative care services with implementation of the standards.Significance of results:The bereavement standards and care pathway constitute a key initiative in the evolution of bereavement support provided by palliative care services. Future endeavors should refine and examine the impact of these standards. Additional research is required to enhance systematic approaches to quality bereavement care.

scholarly journals Palliative Care During COVID-19: Data and Visits From Loved Ones

2020 ◽  
Vol 37 (11) ◽  
pp. 988-991 ◽  
Author(s):  
Laura Heath ◽  
Sharon Yates ◽  
Matthew Carey ◽  
Mary Miller
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Laboratory Diagnosis ◽  
Tertiary Hospital ◽  
Nasopharyngeal Swab ◽  
Loved One ◽  
Management Plans ◽  
Vital Component ◽  
The Impact

Objectives: A vital component of the coronavirus response is care of the dying COVID-19 patient. We document the demographics, symptoms experienced, medications required, effectiveness observed, and challenges to high-quality holistic palliative care in 31 patients. This will aid colleagues in primary and secondary care settings anticipate common symptoms and formulate management plans. Methods: A retrospective survey was conducted of patients referred to the hospital palliative care service in a tertiary hospital, south east of England between March 21 and April 26, 2020. Patients included had a confirmed laboratory diagnosis of COVID-19 via reverse transcription polymerase chain reaction nasopharyngeal swab for SARS-Cov-2 or radiological evidence of COVID-19. Results: The thirty-one patients included were predominantly male (77%), elderly (median [interquartile range]: 84 [76-89]), and had multiple (4 [3-5]) comorbidities. Referral was made in the last 2 [1-3] days of life. Common symptoms were breathlessness (84%) and delirium (77%). Fifty-eight percent of patients received at least 1 “as required” dose of an opioid or midazolam in the 24 hours before death. Sixty percent of patients needed a continuous subcutaneous infusion and the median morphine dose was 10 mg S/C per 24 hours and midazolam 10 mg S/C per 24 hours. Nineteen percent of our cohort had a loved one or relative present when dying. Conclusion: We provide additional data to the internationally reported pool examining death arising from infection with SARS-CoV-19. The majority of patients had symptoms controlled with low doses of morphine and midazolam, and death was rapid. The impact of low visitation during dying needs exploring.

The Impact of Socioeconomic Status on Place of Death Among Patients Receiving Home Palliative Care in Toronto, Canada: A Retrospective Cohort Study

2019 ◽  
Vol 35 (3) ◽  
pp. 167-173
Author(s):  
Joshua Wales ◽  
Sumeet Kalia ◽  
Rahim Moineddin ◽  
Amna Husain
Keyword(s):  
Socioeconomic Status ◽  
Palliative Care ◽  
Acute Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Place Of Death ◽  
Income Quintile ◽  
Home Death ◽  
Home Based ◽  
The Impact

Background: Socioeconomic disparities in home death have been noted in the literature. Home-based palliative care increases access to home death and has been suggested as a means to decrease these disparities. Aim: Our study examines the association between socioeconomic status and other demographic factors on place of death in a population receiving home palliative care in Toronto, Canada. Design: This is a retrospective chart review of patients who died between August 2013 and August 2015 when admitted to a home-based palliative care service. Multivariate multinomial regression examined the relationship between the place of death (home, palliative care unit [PCU], or acute care) with age, gender, primary diagnosis, and income quintile. Bivariate logistic regression was fitted to calculate the odds ratio (OR) and probability of preference for home death. Setting/Participants: Patients receiving home-based palliative care services from the Latner Centre for Palliative Care in Toronto, Canada. Results: A total of 2066 patients were included in multivariate analysis. Patients in the lowest income quintile had increased odds of dying in acute care (OR = 2.41, P < .001) or dying in PCU (OR = 1.64, P = .008) than patients in highest income quintile. Patients in the next lowest income quintiles 2 and 3 were also more likely to die in acute care. The rate of preference for home death was significantly lower in the lowest income quintile (OR = 0.47, P = .0047). Conclusions: Patients in lower income quintiles are less likely to die at home, despite receiving home-based palliative care, although they may also be less likely to prefer home death.

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