The role of palliative care unit co-operating with regional medical systems to provide reliable patient care

45 Background: Home death rate is increasingly being used as a quantifiable indicator of the effectiveness of palliative care services. Intensifying home care and training of the end-of-life care practitioners, seems to be the way to improve the correlation between patient preferences and actual place of death. The objective of this study is to measure the impact of a multidisciplinary home palliative care unit (HPCU) (including medical, nursery, and psycological care, and social worker counselling) on the place of death of patients treated in a single oncology service. Methods: A retrospective case-control study was performed. HPCU patients consecutively admitted from January 2014 to June 2015 (cases) were matched with contemporary patients from the same center who could be followed by independent support services (Home Hospitalization, Psicooncologists and General Practitioners) (controls) by diagnosis, sex, age group ( < 60 years, 61-75y and > 75y) and oncologist physician. Place of death was registered. Odds ratio (ORR) and relative risk was analysed with SPSS for Windows ver.22.00. Results: Seventy four patients (p) admitted in a HPCU and their controls were included; 54% men; Average of age in cases 69.7years (y) (SD 10.8) and controls 68.5 y (SD 10.41), diagnosed of lung cancer 20p (27%), breast cancer 6p (8%), gastrointestinal noncolorectal cancer 16p (22%), colorectal cancer 10p (13.5%), head and neck cancer 5p (6.8%), genitourinary cancer 12p (16%), metastatic melanoma 2p, advanced sarcoma 2p and unknown primary cancer 1p. Place of death: home (cases 43p [59%], controls 8p [10%]); emergency service (1p [1.4%] vs 3p [4.1%]); in acute hospital in-patient-care (AH) (11p [15.1%] vs 29 p [39.2%]) and at a hospitalized palliative care unit (18p [24.7%], vs 34p [45.9%]); 1p of case group was lost during follow-up. The ORR for dying at home for HPCU patients was 11.82 (IC 95% 4.95-28.02) and a reduction in risk of die in an AH was seen (0.38, IC 95% 0.21-0.67). Conclusions: Death at home seems to be more feasible if cancer diagnosed patients have a proper follow-up by a multidisciplinary home palliative care unit, and it also reduce the possibility of dying in an acute hospital in-patient-care.

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Changing hospital culture: the role of an acute palliative care unit

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2012-000196.260 ◽

2012 ◽

Vol 2 (Suppl 1) ◽

pp. A88.3-A89

Author(s):

Fiona Paterson ◽

Deans Buchanan ◽

Frances MacIvor ◽

Susan Lundie ◽

Pamela Levack ◽

...

Keyword(s):

Palliative Care ◽

Palliative Care Unit ◽

Hospital Culture

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Snapshot of an acute palliative care unit in a tertiary cancer hospital

Palliative & Supportive Care ◽

10.1017/s1478951513000722 ◽

2013 ◽

Vol 12 (4) ◽

pp. 331-337 ◽

Cited By ~ 2

Author(s):

Akhila Reddy ◽

Marieberta Vidal ◽

Maxine de la Cruz ◽

Sriram Yennurajalingam ◽

Eduardo Bruera

Keyword(s):

Palliative Care ◽

The United States ◽

Palliative Care Unit ◽

Psychosocial Issues ◽

Special Report ◽

Working Together ◽

Consultation Services ◽

Specialized Unit

AbstractMost palliative care (PC) programs in the United States provide consultation services that assist the primary medical team with issues ranging from controlling patients' symptoms to initiating end-of-life discussions. This approach may be sufficient to address many patients' needs. However, for certain patients with complex medical and psychosocial issues, a better alternative is a more streamlined approach that can be provided in an acute palliative care unit (APCU), where the PC staff assumes the role of the primary team. An APCU is a specialized unit that delivers highly sophisticated care with professionals from various disciplines working together to improve the quality of life of patients and their families. However, descriptions of the process of delivering PC in the APCU are limited. In this special report, we portray a single day with a series of patients whose care was managed at our APCU to illustrate the unique components of an APCU that allow holistic care for patients with multiple complex medical and psychosocial issues.

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Temporary Communication Infrastructures for Dynamic KM in the Complex and Innovative Environment of Palliative Care

Creating Knowledge-Based Healthcare Organizations ◽

10.4018/978-1-59140-459-0.ch020 ◽

2005 ◽

pp. 270-285

Author(s):

Graydon Davison

Keyword(s):

Palliative Care ◽

Patient Care ◽

Holistic Care ◽

Care Processes ◽

Innovative Environment ◽

Palliative Care Teams ◽

Research Interviews ◽

The Individual ◽

Multidisciplinary Patient Care

Research in Australia on the management of innovative practices in multidisciplinary palliative care teams reveals the central role of knowledge as an enabler of holistic care in an environment where sometimes little, apart from the result of the end of life process, is operationally predictable. While palliative care organisations provide, and regulators require, opportunities for formal exchange, recording and review of patient-based information and patient care processes; the members of care teams require and construct more frequent opportunities for the exchange of information and the generation and application of knowledge. Multidisciplinary patient care teams are resourced to and capable of constructing real-time temporary communication infrastructures between the team’s different disciplinary representatives, between teams as necessary and between teams and the organisation, for individual patient situations. This chapter describes the organisational capabilities and levers necessary for providing an environment within which these infrastructures can be created and the individual behaviours and team tools that are used in the process, based on a wide ranging literature review and the results of research interviews.

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Branding Palliative Care Units by Avoiding the Terms “Palliative” and “Hospice”

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/0046958016686449 ◽

2017 ◽

Vol 54 ◽

pp. 004695801668644 ◽

Cited By ~ 6

Author(s):

Ying-Xiu Dai ◽

Tzeng-Ji Chen ◽

Ming-Hwai Lin

Keyword(s):

Palliative Care ◽

Public Hospitals ◽

Palliative Care Unit ◽

Private Hospitals ◽

Religiously Affiliated ◽

Negative Perceptions ◽

Palliative Care Units ◽

The Government ◽

Patient Referrals

The term “palliative care” has a negative connotation and may act as a barrier to early patient referrals. Rebranding has thus been proposed as a strategy to reduce the negative perceptions associated with palliative care. For example, using the term “supportive care” instead of “palliative care” in naming palliative care units has been proposed in several studies. In Taiwan, terms other than “palliative” and “hospice” are already widely used in the names of palliative care units. With this in mind, this study investigated the characteristics of palliative care unit names in order to better understand the role of naming in palliative care. Relevant data were collected from the Taiwan Academy of Hospice Palliative Medicine, the National Health Insurance Administration of the Ministry of Health and Welfare, and the open database maintained by the government of Taiwan. We found a clear phenomenon of avoiding use of the terms “palliative” and “hospice” in the naming of palliative care units, a phenomenon that reflects the stigma attached to the terms “palliative” and “hospice” in Taiwan. At the time of the study (September, 2016), there were 55 palliative care units in Taiwan. Only 20.0% (n = 11) of the palliative care unit names included the term “palliative,” while 25.2% (n = 14) included the term “hospice.” Religiously affiliated hospitals were less likely to use the terms “palliative” and “hospice” (χ2 = 11.461, P = .001). There was also a lower prevalence of use of the terms “palliative” and “hospice” for naming palliative care units in private hospitals than in public hospitals (χ2 = 4.61, P = .032). This finding highlights the strong stigma attached to the terms “palliative” and “hospice” in Taiwan. It is hypothesized that sociocultural and religious factors may partially account for this phenomenon.

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