Introduction to Sex-Positive Palliative Care: Best Practices and Interventions

2020 ◽  
Author(s):  
Stephanie C. Chando ◽  
Erin M. Haley ◽  
Caitlyn M. Moore ◽  
Monique Neault
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Sex Positive

Medical-Legal Partnership: Lessons from Five Diverse MLPs in New Haven, Connecticut

2018 ◽  
Vol 46 (3) ◽  
pp. 602-609 ◽  
Author(s):  
Emily A. Benfer ◽  
Abbe R. Gluck ◽  
Katherine L. Kraschel
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Social Determinants ◽  
Research Agenda ◽  
Evidence Base ◽  
Law School ◽  
New Haven ◽  
Formerly Incarcerated ◽  
Patients With Cancer ◽  
The Social

This article examines five different Medical-Legal Partnerships (MLPs) associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, and best practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the “L” has been lacking and is overdue.

Developing a virtual collaborative to facilitate palliative care and quality improvement learning in oncology.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 252-252 ◽  
Author(s):  
Arif Kamal ◽  
Kristen McNiff ◽  
Ann A. Prestrud ◽  
Dale Lupu ◽  
Molly Gavigan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Best Practices ◽  
Technology Development ◽  
Evidence Base ◽  
Evaluation Methods ◽  
Quality Improvement Intervention ◽  
Learning Collaborative ◽  
Care Needs ◽  
Oncology Practice

252 Background: Despite a strong evidence base and increasing calls for integration, oncologists find it difficult to deliver primary palliative care concurrent with standard oncology care. Solutions that promote practical integration of palliative care in oncology are needed. In an AHRQ-funded pilot, ASCO and the American Academy of Hospice and Palliative Medicine are developing the Virtual Learning Collaborative (VLC) to develop and test a scalable model for quality improvement and dissemination of best practices in palliative care within the oncology setting. Methods: The VLC will be a web-based learning and collaboration system built upon existing ASCO technology resources. We will select at least 25 oncology practices to participate in regular, facilitated learning sessions, collaborative discussions, and sharing of best practices. The VLC will equip each practice with the knowledge, tools, and coaching to select, test, and adopt a quality improvement intervention relevant to their own palliative care needs. Development of the VLC is ongoing; oncology practices begin participation in Spring 2014. Results: We will assess the VLC using protocol-driven evaluation methods common to technology development, quality improvement, implementation science, and educational initiatives. VLC usability, feasibility, and acceptability will be assessed through surveys of participating practices and focus groups. Longitudinal changes in conformance to palliative care metrics will be assessed using ASCO’s Quality Oncology Practice Initiative (QOPI) system. We will use mixed qualitative and quantitative evaluation methods to assess ongoing changes in clinician knowledge and self-efficacy in applying palliative care principles. Conclusions: We aim to develop and test a novel method for facilitating quality improvement and palliative care learning in oncology. Through this pilot, we will refine the VLC for implementation in the greater oncology community. Ultimately, this effort supports other ASCO and AAHPM quality improvement initiatives focused on clinician education and dissemination of best practices.

scholarly journals Coordination of Care Within a Mobile Palliative Care Team and Organization of a Continuing Education Program for Health Professionals in Palliative Care

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 62s-62s
Author(s):  
A. Mubeneshayi Kananga
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Continuing Education ◽  
Health Professionals ◽  
National Policy ◽  
Palliative Care Team ◽  
Care Team ◽  
Terminal Phase ◽  
Dr Congo ◽  
Mobile Team

Background: In DR Congo (DRC), many cancer patients in the terminal phase of their condition have minimal access to palliative care. There is a combined effect of poverty, the deterioration of the health system and the absence of a well-defined national policy on palliative care. Patients are for the most part abandoned to the care of inexperienced family members. Founded in 2009, Palliafamilli aims to improve the quality of life of patients requiring palliative care in the DRC by providing visits and care for patients, by striving to increase access to palliative care in the region and by informing, raising awareness and mobilizing key national stakeholders. In September 2018, Palliafamilli will launch a mobile palliative care team (MPCT) in partnership with the general hospital of Ndjili in Kinshasa. The MPCT is an interdisciplinary team consisting of physicians, nurses, a psychologist and a project manager; all experienced in accompaniment, symptom management and palliative emergency. It has a consultancy role for professionals, patients and their caregivers. Aim: Through a African Cancer Fellowship award, I will visit a mobile team of palliative care from CHRU Besançon, France, for one month in May 2018 to gain experience in designing and implementing best practices for a mobile palliative care team. Methods: I will work closely with the mobile palliative care team of the Besançon Regional Hospital Center to gain experience regarding the coordination and care administration of palliative care within a mobile team. I will also learn about the different programs of continuing education for health professionals, make comparisons and adapt the programs to the reality of DR Congo. Results: With a view to promoting access to palliative care patients, I intend to learn from the host organization the best practices that they apply to overcome communication difficulties with the patient and their relatives which can constitute delays to access to adequate care. This delay is more marked for patients suffering from cancer because the evolution of their pathology is unpredictable. The main barriers are the insufficient knowledge of patients' needs and the opportunities offered by palliative care. Upon my return, I will adapt the best practices learned in France to the DRC context during the launch of the new mobile palliative care team. Conclusion: In Congo, a cross-cutting approach is required to provide patients with palliative care and pain relief, as resources are limited, many people are in need of care, and there are few nurses and doctors empowered to provide care. An effective approach is to involve community or volunteer caregivers supervised by health professionals, and Palliafamilli is successful due in its multidisciplinary and multisectoral approach, with adaptation to cultural, social and economic specificities and its integration with existing health systems, focusing on primary health care and community and home care.

Formation of an international quality improvement collaborative for palliative care: The Global Palliative Care Quality Alliance (GPCQA).

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 91-91
Author(s):  
Arif Kamal ◽  
Jonathan Nicolla ◽  
Fred Friedman ◽  
Charles S. Stinson ◽  
Laura Patel ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Data Collection ◽  
Best Practices ◽  
Point Of Care ◽  
Shared Vision ◽  
Care Quality ◽  
Quality Data ◽  
Spiritual Assessment ◽  
National Quality

91 Background: Formal mechanisms to share data on quality remain immature in specialty palliative care. As the field grows, infrastructure that promotes collaboration among academic and community-based practice will be required to foster comparisons and benchmarking of data to inform areas for quality improvement. Further, such relationships will create a palliative care “quality improvement laboratory”, where proposed guidelines and best practices can be developed, implemented, and tested. Methods: We set out to bring together specialty palliative care practices with a shared vision for collaborative quality improvement. We modeled our approach after the Institute for Healthcare Improvement Breakthrough Series alongside our Rapid Learning Quality Improvement paradigm. We use a set of common data collection procedures, across an electronic point-of-care platform called Quality Data Collection Tool (QDACT), alongside a centralized data registry. Further, we meet and discuss challenges and issues, compare best practices, and brainstorm new projects through biweekly conference calls. Results: We have created a multi-institutional collaboration for quality assessment and improvement in specialty palliative care. Termed the Global Palliative Care Quality Alliance, we have brought together 11 academic and community organizations, both general and oncology-specific, across six states to study various areas of quality practice. Short-term, we will conduct rapid-cycling quality improvement projects addressing National Quality Forum domains for quality palliative care, including documentation of spiritual assessment and timely advance care planning. Long-term, we aim to study the link between quality measure adherence and outcomes and further align our initiatives with those of other large consortia, like the Palliative Care Research Cooperative and Palliative Care Quality Network. Conclusions: Collaborative quality improvement is needed in specialty palliative care across a national platform. Developing the infrastructure to perform standardized quality improvement is achievable across multiple palliative care settings.

Best Practices, Enduring Challenges, and Opportunities for VSED

2021 ◽  
pp. 126-130
Author(s):  
Timothy E. Quill ◽  
Paul T. Menzel ◽  
Thaddeus M. Pope ◽  
Judith K. Schwarz
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Best Practices ◽  
Advance Directives ◽  
Symptom Management ◽  
Early Phase ◽  
Terminal Illness ◽  
Care Providers ◽  
Decision Making Capacity ◽  
Challenges And Opportunities

VSED begins with excellent symptom management supported by experienced clinicians. VSED is largely patient controlled, but involvement of experienced palliative care providers and family is strongly recommended. Decision making capacity is frequently lost late in the process as death nears, so written advance directives to continue withholding food and fluids should be completed prior to initiating VSED to forestall any misunderstandings of the patient’s wishes. Challenges associated with VSED include its two week duration before death, the personal determination required, and the possibility of delirium in the latter stages that potentially compromises the commitment to forgo fluids. These challenges should be anticipated and planned for. The primary advantages of VSED include: 1) predictable two week duration from initiation to death; 2) alertness for the early phase, 3) no terminal illness requirement, 4) largely under the patient’s control, and 5) awareness of the possibility of VSED can provide comfort to those worried about unacceptable future suffering.

Supporting Families and Family Caregivers in Palliative Care

2019 ◽  
pp. 405-419
Author(s):  
Kelli I. Stajduhar ◽  
J. Nicholas Dionne-Odom
Keyword(s):  
Palliative Care ◽  
Best Practices ◽  
Family Caregivers ◽  
Healthcare System ◽  
Family Caregiver ◽  
Care Home ◽  
Community Resources ◽  
Vital Part ◽  
The Family ◽  
Specialized Unit

This chapter investigates best practices for nurses who are involved in supporting families and family caregivers in palliative care. It views the family as a specialized unit of care which contributes to the healthcare system in a substantive way. There are significant implications for families and family caregivers in taking on these responsibilities, and nurses play a vital part in maintaining the integrity and health of the family and family caregiver. With a focus on palliative care, specific suggestions are made for nurses’ assessments in identifying needs and providing subsequent interventions. Particular sites of care (home, acute, etc.) and implications arising from a range of disease categories are discussed. The chapter concludes with recommendations for identifying community resources.

scholarly journals Monitoring the Italian Home Palliative Care Services

Healthcare ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 4 ◽  
Author(s):  
Gianlorenzo Scaccabarozzi ◽  
Pietro Giorgio Lovaglio ◽  
Fabrizio Limonta ◽  
Carlo Peruselli ◽  
Mariadonata Bellentani ◽  
...  
Keyword(s):  
Palliative Care ◽  
Data Collection ◽  
Best Practices ◽  
Home Care ◽  
Cancer Patients ◽  
Best Practice ◽  
Activity Data ◽  
Care Services ◽  
Palliative Care Services ◽  
Year 2013

Background: In Italy, there currently is a lack of reliable and consistent data on home palliative care provided to people near death. Objectives: Monitoring the activities of the Italian Home Palliative Care Services, according to the 2014 national data collection program entitled “Observatory of Best Practices in Palliative Care” and providing process/outcome measures on a subsample (Best Practice Panel), on regulatory standards and on complete/reliable activity data. Design: A data collection web portal using two voluntary internet-based questionnaires in order to retrospectively identify the main care activity data provided within the year 2013 by Home care units. In the Best Practice Panel and International best practices, eligibility and quality measures refer to the national standards of the NL 38/2010. Setting/Subject: Home Palliative Care Services (HPCSs) that provided care from January to December 2013. Results: 118 Home care units were monitored, globally accounting for 40,955 assisted patients within the year 2013 (38,384 cancer patients); 56 (47.5% of 118) were admitted in the Best Practice Panel. Non-cancer (5%) and pediatric (0.4%) patients represented negligible percentages of frail care patients, and a majority of patients died at home (respectively nearly 75% and 80% of cancer and non-cancer patients). Conclusion: The study demonstrated the feasibility of the collection of certified data from Home care services through a web-based system. Only 80% of the facilities met the requirements provided by the Italian NL 38/2010. Moreover, the extension of the palliative care services provided to frail non-cancer and pediatric patients, affected by complex and advanced chronic conditions, is still inadequate in Italy.

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