Using simulation modelling to test the impact of future demand for end-of-life care

2018 ◽  
Vol 31 (4) ◽  
pp. 147-152 ◽  
Author(s):  
Eileen Florence Pepler ◽  
Janet Davidson ◽  
Douglas McGregor ◽  
Keith Poore ◽  
Stephen Brown ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Discrete Event ◽  
Population Level ◽  
Simulation Modelling ◽  
Models Of Care ◽  
Life Care ◽  
For Profit ◽  
Care Models ◽  
The Impact

Health systems globally are exploring new models of care to address the increasing demand for palliative, hospice, and end-of-life care. Yet few tools exist at the population level to explore “what if” scenarios and test, in a “cost avoidance environment,” the impact of these new care models on policy, workforce, technology, and funding. This article introduces the application of scenario-based “what if” thinking and discrete event simulation in strategic planning for a not-for-profit hospice organization. It will describe how a set of conceptual models was designed to frame discussions between strategic partners about the implications and alternatives in implementing a new, integrated service model for palliative and end-of-life care.

scholarly journals The Impact of Nursing Homes Staff Education on End-of-Life Care in Residents With Advanced Dementia: A Quality Improvement Study

2019 ◽  
Vol 57 (1) ◽  
pp. 93-99 ◽  
Author(s):  
Paola Di Giulio ◽  
Silvia Finetti ◽  
Fabrizio Giunco ◽  
Ines Basso ◽  
Debora Rosa ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Advanced Dementia ◽  
Staff Education ◽  
The Impact

scholarly journals Nursing care at end of life: a UK-based survey of the deaths of people living in care settings for people with intellectual disability

2018 ◽  
Vol 24 (6) ◽  
pp. 366-382 ◽  
Author(s):  
Ruth Northway ◽  
Stuart Todd ◽  
Katherine Hunt ◽  
Paula Hopes ◽  
Rachel Morgan ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
End Of Life ◽  
Nursing Care ◽  
End Of Life Care ◽  
Life Care ◽  
Care Providers ◽  
Nursing Support ◽  
Respiratory Problems ◽  
The Uk ◽  
The Impact

Background People with intellectual disability are believed to be at risk of receiving poor end-of-life care. Nurses, given their advocacy role and duty to provide compassionate end-of-life care, have the potential to change this situation but research regarding this aspect of their role is limited. Aims This paper thus seeks to answer the question ‘How and when are nurses involved in providing care at end of life for people with intellectual disability?’ Methods A total of 38 intellectual disability care providers in the UK providing support to 13,568 people with intellectual disability were surveyed. Data regarding 247 deaths within this population were gathered in two stages and subsequently entered into SPSSX for analysis. Results Findings revealed that the majority of deaths occurred between the ages of 50 and 69 years, the most commonly reported cause of death being respiratory problems. Both community and hospital-based nurses were involved in supporting individuals during their final 3 months of life, and sometimes more than one type of nurse provided support to individuals. Generally nursing care was rated positively, although room for improvement was also identified. Conclusions Nurses are involved in supporting people with intellectual disability at end of life and appropriate education is required to undertake this role. This may require change in curricula and subsequent research to determine the impact of such change on nursing support to this population.

scholarly journals Measuring indicators of health system performance for palliative and end-of-life care using health administrative data: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1438
Author(s):  
Suman Budhwani ◽  
Ashlinder Gill ◽  
Mary Scott ◽  
Walter P. Wodchis ◽  
JinHee Kim ◽  
...  
Keyword(s):  
Performance Measurement ◽  
End Of Life ◽  
Administrative Data ◽  
Scoping Review ◽  
System Performance ◽  
End Of Life Care ◽  
Population Level ◽  
Health System Performance ◽  
Life Care ◽  
Health Administrative Data

Background: A plethora of performance measurement indicators for palliative and end-of-life care currently exist in the literature. This often leads to confusion, inconsistency and redundancy in efforts by health systems to understand what should be measured and how.  The objective of this study was to conduct a scoping review to provide an inventory of performance measurement indicators that can be measured using population-level health administrative data, and to summarize key concepts for measurement proposed in the literature.  Methods: A scoping review using MEDLINE and EMBASE, as well as grey literature was conducted.  Articles were included if they described performance or quality indicators of palliative and end-of-life care at the population-level using routinely-collected administrative data.  Details on the indicator such as name, description, numerator, and denominator were charted. Results: A total of 339 indicators were extracted.  These indicators were classified into nine health care sectors and one cross-sector category.  Extracted indicators emphasized key measurement themes such as health utilization and cost and excessive, unnecessary, and aggressive care particularly close to the end-of-life.  Many indicators were often measured using the same constructs, but with different specifications, such as varying time periods used to ascribe for end-of-life care, and varying patient populations.  Conclusions: Future work is needed to achieve consensus ‘best’ definitions of these indicators as well as a universal performance measurement framework, similar to other ongoing efforts in population health.  Efforts to monitor palliative and end-of-life care can use this inventory of indicators to select appropriate indicators to measure health system performance.

scholarly journals The Impact of End-of-life Care Simulation on Resilience for Nursing Students: A Study by Randomized Controlled Trial

2020 ◽  
Vol 15 (2) ◽  
pp. 153-160
Author(s):  
Yumie Yokoi ◽  
Tomoko Tamaki ◽  
Anri Inumaru ◽  
Makoto Fujii ◽  
Mayumi Tsujikawa
Keyword(s):  
Randomized Controlled Trial ◽  
Nursing Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Controlled Trial ◽  
Life Care ◽  
Randomized Controlled ◽  
The Impact

First steps: Health and social care professionals beginning to address the palliative and end of life care needs of people with diverse gender identities and sexual orientations in Lebanon

Sexualities ◽  
2020 ◽  
pp. 136346072093238
Author(s):  
Claude Chidiac
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Social Stigma ◽  
Life Care ◽  
Care Needs ◽  
Mena Region ◽  
Healthcare Needs ◽  
Health And Social Care ◽  
The Impact

The available evidence demonstrates that lesbian, gay, bisexual, and transgender (LGBT) people face challenges when accessing palliative care services, and receive suboptimal care at the end of life. This is mainly attributed to assumed heterosexuality, lack of knowledge and understanding of LGBT issues and specific healthcare needs, discrimination, homophobia, and transphobia. In Lebanon, legal and institutional support for LGBT individuals is minimal, and palliative care provision remains scarce and fragmented. This compounds the impact of social stigma and marginalisation, and results in unrecognised palliative and end of life care needs for the LGBT individual. This short commentary discusses the development of an LGBT palliative care workshop in Lebanon, which was the first initiative of its kind in the Middle East and North Africa (MENA) region. It also explores how this initiative has led to further developments, and how these efforts can be replicated in other countries in the MENA region.

scholarly journals 116 Measuring the impact of end of life care quality improvement (qi) projects

2018 ◽  
Author(s):  
S Kite ◽  
A Cracknell ◽  
A Hurlow ◽  
C Iwaniszak ◽  
C Pattison ◽  
...  
Keyword(s):  
Quality Improvement ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Quality ◽  
Life Care ◽  
The Impact

Approaching end-of-life care in organ transplantation: the impact of transplant patients' death and dying

2007 ◽  
Vol 17 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Linda Wright ◽  
Deborah Pape ◽  
Kelley Ross ◽  
Michael Campbell ◽  
Kerry Bowman
Keyword(s):  
End Of Life ◽  
Organ Transplantation ◽  
End Of Life Care ◽  
Death And Dying ◽  
Life Care ◽  
Transplant Patients ◽  
The Impact

The impact of a one month palliative care rotation on medical residents working in a tertiary cancer center in Jordan.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 168-168
Author(s):  
Omar M. Shamieh ◽  
Alia Alawneh ◽  
Wafa Ahamd ◽  
Sewar S Salmany ◽  
Barakat Altamimi ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Medical Residents ◽  
Cancer Center ◽  
Clinical Rotation ◽  
Life Care ◽  
The Impact ◽  
Tertiary Cancer Center

168 Background: Palliative care education and training remains inadequate for medical professionals especially in developing countries. We evaluated the impact of a one month palliative care clinical rotation on medical residents’ attitude, competency, and knowledge related to palliative care in a tertiary cancer center in Jordan. Methods: All transitional Internal Medicine residents rotated in a monthly palliative care rotation at King Hussein Cancer Center (KHCC), in Amman, Jordan, were requested to participate in this educational intervention study. A concise curriculum in palliative and end of life care, adapted from the Education for Physicians on End-Of-Life Care (EPEC) Curriculum and delivered by our faculty was piloted as a part of the clinical rotation. Residents spent one month in the inpatient palliative care unit, in addition to 10 hours of classroom interactive sessions. The curriculum comprised of five modules: 1- Principles of palliative care, 2- Pain management, 3- Management of distressing symptoms, 4- Communication skills, 5- End-of- life care. To assess our educational outcomes, we adapted a previously developed instruments by David Weisman and used by the National Residency Education in the United States. All Instruments were completed by each resident before and after the rotation, and included self-assessment of attitude, competency and a knowledge test comprising of 32-items of multiple choice questions. Results: Twenty of 27 (74%) residents who started the palliative care rotation completed the required education and had paired evaluations. There was improvement in all three instruments: 37% improvement in competence (p < 0.0001), 17% Improvement in knowledge (p = 0.015), and 5% improvement in attitude (p = 0.02). Conclusions: The one-month mandatory rotation improved knowledge, attitude and competence related to palliative care for medical residents.

Non-professional carers' views on the care of the dying; the impact of a simple end-of-life care tool

2011 ◽  
Vol 1 (Suppl_1) ◽  
pp. A19-A19
Author(s):  
K. Forbes ◽  
J. Gibbins ◽  
M. E. Burcombe ◽  
S. J. Bloor ◽  
C. M. Reid ◽  
...  
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
The Impact ◽  
Care Of The Dying
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