scholarly journals Strengthening palliative care in the hospital setting: a codesign study

2020 ◽  
pp. bmjspcare-2020-002645
Author(s):  
Claudia Virdun ◽  
Tim Luckett ◽  
Patricia M Davidson ◽  
Jane Phillips
Keyword(s):  
Palliative Care ◽  
Group Process ◽  
Hospital Setting ◽  
Nominal Group ◽  
Care Needs ◽  
Hospital Policy ◽  
Policy Practice ◽  
Advance Care ◽  
Executive Level ◽  
Palliative Care Needs

ObjectiveTo identify actions required to strengthen the delivery of person and family centred hospital-based palliative care so that it addressed the domains of care identified as important for inpatients with palliative care needs and their families.MethodsA codesign study involving a workshop with palliative care and acute hospital policy, consumer and clinical representatives in Australia. A modified nominal group process generated a series of actions, which were thematically analysed and refined, before being circulated to participants to gain consensus.ResultsMore than half (n=30, 58%) of the invited representatives (n=52) participated in the codesign process. Nine actions were identified as required to strengthen inpatient palliative care provision being: (a) evidence-informed practice and national benchmarking; (b) funding reforms; (c) securing executive level support; (d) mandatory clinical and ancillary education; (e) fostering greater community awareness; (f) policy reviews of care of the dying; (g) better integration of advance care planning; (h) strengthen nursing leadership; and (i) develop communities of practice for improving palliative care.ConclusionsChanges to policy, practice, education and further research are required to optimise palliative care within hospital settings, in accordance with the domains inpatients with palliative care needs and their families consider to be important. Achieving these changes will require a whole of sector approach and significant national and jurisdictional leadership.

scholarly journals Identifying Palliative Care Needs in Assisted Living

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 788-788
Author(s):  
Daniel David ◽  
Abraham Brody ◽  
Tina Sadarangani ◽  
Bei Wu ◽  
Tara Cortez
Keyword(s):  
Palliative Care ◽  
Assisted Living ◽  
Unmet Needs ◽  
Care Needs ◽  
Code Status ◽  
Care Services ◽  
Palliative Care Services ◽  
Advance Care ◽  
Palliative Care Needs

Abstract Many residents of Assisted Living (AL) confront serious illness and therefore might benefit from greater access to Palliative Care Services to improve quality of life. We surveyed resident records and AL nursing staff to identify patients in need of Palliative Care. Preliminary findings showed that nurses predicted 23% would not be alive and 49% would no longer live in AL. A majority of residents were over the age of 90, yet 30% did not have a reported code status. These findings suggest that a substantial portion of AL residents may have unmet needs with respect to palliative care. Future interventions are needed to support advance care planning conversations and make palliative care more accessible to this population.

scholarly journals The impact of the environment on patient experiences of hospital admissions in palliative care

2015 ◽  
Vol 8 (4) ◽  
pp. 485-492 ◽  
Author(s):  
Jackie Robinson ◽  
Merryn Gott ◽  
Clare Gardiner ◽  
Christine Ingleton
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Hospital Admissions ◽  
Hospital Setting ◽  
Prognostic Indicators ◽  
Care Needs ◽  
Acute Hospitals ◽  
Almost All ◽  
The Impact ◽  
Palliative Care Needs

ObjectiveTo explore the impact of environment on experiences of hospitalisation from the perspective of patient's with palliative care needs.MethodsA qualitative study design using longitudinal semistructured, face-to-face interviews were used to elicit the views of patients with palliative care needs admitted to hospital in 1 large urban acute hospital in New Zealand. The sample comprised of 14 patients admitted to hospital between July 2013 and March 2014 who met one of the Gold Standard Framework Prognostic Indicators for palliative care need.ResultsAlmost all participants described a range of factors associated with the environment which impacted negatively on their experiences of hospitalisation. This included challenges with the physical surroundings, the impact on social relationships with other patients, families and health professionals and the influence of the cultural milieu of the hospital setting.ConclusionsEmulating the ‘ideal’ environment for palliative care such as that provided in a hospice setting is an unrealistic goal for acute hospitals. Paying attention to the things that can be changed, such as enabling family to stay and improving the flexibility of the physical environment while improving the social interplay between patients and health professionals, may be a more realistic approach than replicating the hospice environment in order to reduce the burden of hospitalisations for patients with palliative care needs.

scholarly journals Feasibility of hospital-initiated non-facilitator assisted advance care planning documentation for patients with palliative care needs

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Maaike Kok ◽  
Gertruud F. M. van der Werff ◽  
Jenske I. Geerling ◽  
Jaap Ruivenkamp ◽  
Wies Groothoff ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Care Planning ◽  
Care Planning ◽  
Care Needs ◽  
Advance Care ◽  
Palliative Care Needs

Cardiopulmonary System

2021 ◽  
pp. 181-197
Author(s):  
Kimberly Angelia Curseen ◽  
Jabeen Taj
Keyword(s):  
Palliative Care ◽  
Standard Of Care ◽  
Physician Assistants ◽  
Care Providers ◽  
Care Needs ◽  
System P ◽  
Life Issues ◽  
Advance Care ◽  
End Of Life Issues ◽  
Palliative Care Needs

The broad range of palliative care needs are similar in cardiopulmonary disease as in other forms of serious illness. As new interventions reshape their clinical course and prognosis, palliative care has become the new standard of care for patients with serious cardiac/pulmonary diseases. Palliative care providers, including physician assistants, will need to be adept in advanced symptom management and communication skills that are unique to this for both patients and caregivers. This specialty provides opportunities for more nuanced advance care planning and goals-of-care discussions. In addition, earlier primary palliative care will provide more time to address end-of-life issues that are inherent to the care of this population—leading to a smoother transition to hospice.

An Interventional Study for the Early Identification of Patients With Palliative Care Needs and the Promotion of Advance Care Planning and Advance Directives

2020 ◽  
Vol 59 (5) ◽  
pp. 974-982.e3 ◽  
Author(s):  
Yung-Feng Yen ◽  
Ya-Ling Lee ◽  
Hsiao-Yun Hu ◽  
Yun-Ju Lai ◽  
Wen-Jung Sun ◽  
...  
Keyword(s):  
Palliative Care ◽  
Advance Directives ◽  
Advance Care Planning ◽  
Early Identification ◽  
Care Planning ◽  
Interventional Study ◽  
Care Needs ◽  
Advance Care ◽  
Palliative Care Needs

scholarly journals Extent of palliative care need in the acute hospital setting: A survey of two acute hospitals in the UK

2012 ◽  
Vol 27 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Clare Gardiner ◽  
Merryn Gott ◽  
Christine Ingleton ◽  
Jane Seymour ◽  
Mark Cobb ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Staff ◽  
Medical Staff ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Self Report ◽  
Care Needs ◽  
Acute Hospitals ◽  
Palliative Care Needs ◽  
Acute Hospital Setting

Background: In common with international health policy, The End of Life Care Strategy for England has highlighted the delivery of high quality palliative care in the acute hospital setting as an area of priority. Aim: The aim of this study was to explore the extent of palliative care need in the acute hospital setting, and to explore agreement between different sources in the identification of patients with palliative care need. Design: A cross-sectional survey of palliative care need was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Medical and nursing staff were asked to identify patients with palliative care needs. Patients (or consultees) completed assessments of palliative care need. Participants: Of a total in-patient population of 1359, complete datasets were collected for 514 patients/consultees. Results: 36.0% of patients were identified as having palliative care needs according to GSF criteria. Medical staff identified 15.5% of patients as having palliative care needs, and nursing staff 17.4% of patients. Patient self-report data indicated that 83.2% of patients meeting GSF criteria had palliative care needs. Conclusion: The results reveal that according to the GSF prognostic guide, over a third of hospital in-patients meet the criteria for palliative care need. Consensus between medical staff, nursing staff and the GSF was poor regarding the identification of patients with palliative care needs. This has significant implications for patient care, and draws into question the utility of the GSF in the hospital setting.

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