Hospital based palliative care teams improve the insight of cancer patients into their disease

2004 ◽  
Vol 18 (1) ◽  
pp. 46-52
Author(s):  
Barbara Jack ◽  
Valerie Hillier ◽  
Anne Williams ◽  
Jackie Oldham
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Assessment Tool ◽  
Symptom Control ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Assessment ◽  
Palliative Care Teams ◽  
The Impact ◽  
Doctors And Nurses

It is reported that cancer patients want as much information as possible about their diagnosis and prognosis. This input regarding patients' insight into their disease is undoubtedly a major part of providing optimal palliative care. Despite this, there is little information regarding the impact of hospital based palliative care teams. An evaluation study comprising a nonequivalent control group design, using a quota sample, investigated 100 cancer patients who had been admitted to hospital for symptom control. Fifty patients received hospital palliative care team intervention compared with 50 patients receiving traditional care. Outcome was assessed using the Palliative Care Assessment tool (PACA) assessment tool on three occasions that measured the patients self-reported understanding of their illness. A supplementary qualitative approach that included 31 semistructured interviews with doctors and nurses to explore their perception of the impact of the palliative care team was also undertaken. The results indicated that cancer patients admitted to hospital for symptom control demonstrated an improvement in their insight to their diagnosis. Those patients who had the additional input of the palliative care team had a significantly greater improvement in their insight scores (reported by the doctors and nurses as being invaluable for the patients). Potential explanations are made for these results including enhanced communication skills of the palliative care team are explored.

Evaluating the impact of early versus late inpatient palliative care consultation for cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6638-6638
Author(s):  
Brian Cassel ◽  
Patrick J. Coyne ◽  
Nevena Skoro ◽  
Kathleen Kerr ◽  
Egidio Del Fabbro
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Palliative Care Team ◽  
Care Team ◽  
Care Hospital ◽  
Palliative Care Consultation ◽  
Social Security Death Index ◽  
Hospital Deaths ◽  
Care Consultation ◽  
The Impact

6638 Background: Access to specialist palliative care (hospital-based or hospice) is a recognized measure of quality in cancer care. Most cancer centers do have palliative care consult services, although the availability of a comprehensive program that includes a palliative care unit and outpatient clinic (Hui 2010) is inconsistent. A simultaneous integrated model of palliative care that facilitates earlier access to a specialized palliative care team may improve clinical outcomes. Palliative care programs should measure the access, timing and impact of their clinical service. Methods: Hospital claims data were linked to Social Security Death Index (SSDI) data from the US Department of Commerce. 3,128 adult cancer patients died between January 2009 and July 2011 and had contact with our inpatient palliative care team in their last six months of life. We determined whether IPC earlier than 1 month prior to death had an impact on hospitalizations, in-hospital mortality and referral to hospice. Results: 27.5% of cancer decedents accessed IPC, median of 22 days before death. 13.2% were discharged to hospice, median of 13 days before death. Patients with IPC earlier than 1 month until death were more likely to have hospice and fewer in-hospital deaths but there was no association between early IPC and a 30-day mortality admission. Conclusions: Palliative care services are accessed by a minority of patients and typically in the last 2-3 weeks of life. Although in-hospital deaths were reduced by earlier palliative care consultation, 30 day mortality did not improve. Hospitals may need to implement other strategies including early integration of outpatient palliative care among cancer patients, to achieve an impact on 30-day mortality admissions. [Table: see text]

Hospital palliative care team survey of symptom control requirements of pancreatic cancer patients

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A71.1-A71
Author(s):  
Sarah De Vos ◽  
Karen Badgery ◽  
Sophie Noble ◽  
Matthew Metcalfe ◽  
William Steward ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
Symptom Control ◽  
Palliative Care Team ◽  
Care Team

scholarly journals Palliative Radiotherapy with or without Additional Care by a Multidisciplinary Palliative Care Team: A Retrospective Comparison

ISRN Oncology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Carsten Nieder ◽  
Kent Angelo ◽  
Astrid Dalhaug ◽  
Adam Pawinski ◽  
Gro Aandahl ◽  
...  
Keyword(s):  
Palliative Care ◽  
Performance Status ◽  
Symptom Control ◽  
Palliative Radiotherapy ◽  
Palliative Care Team ◽  
Care Team ◽  
Dose Fractionation ◽  
Poor Performance Status ◽  
Pattern Of Care ◽  
The Impact

Purpose. To analyze pattern of care and survival after palliative radiotherapy (RT) in patients managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. Methods. Retrospective analysis of 522 RT courses. Comparison of Two Groups: MPCT versus none. Results. We analyzed 140 RT courses (27%) with MPCT care and 382 without it. The following statistically significant differences were observed: 33% of female patients had MPCT care versus only 23% of male patients and 37% of patients <65 years had MPCT care versus only 22% of older patients. MPCT patients were more likely to have poor performance status and liver metastases. In the MPCT group steroid and opioid use was significantly more common. Dose-fractionation regimens were similar. Median survival was significantly shorter in the MPCT group, 3.9 versus 6.9 months. In multivariate analysis, MPCT care was not associated with survival. Adjusted for confounders, MPCT care reduced the likelihood of incomplete RT by 33%, P>0.05. Conclusions. Patterns of referral and care differed, for example, regarding age and medication use. It seems possible that MPCT care reduces likelihood of incomplete RT. Therefore, the impact of MPCT care on symptom control should be investigated and objective referral criteria should be developed.

Palliative medicine

2019 ◽  
pp. 547-556
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Symptom Control ◽  
Occupational Therapists ◽  
Palliative Care Team ◽  
Care Team ◽  
Spiritual Needs ◽  
Patient Symptom ◽  
Inpatient Nursing ◽  
Medical Teams

The chapter underlines the importance of early involvement of the palliative care team to help patients to live better and longer. Palliative care is a multidisciplinary specialty and the role of community and inpatient nursing staff, physiotherapists, occupational therapists, psychologists, and the bereavement, chaplaincy, and medical teams are discussed. The chapter also covers where palliative care is delivered, which can be at home as well as in a hospice or a hospital. Advice is given on where and when medical students can learn the most from the palliative care team, from listening to one of the palliative care consultants take a history to observing the palliative care team prescribing anticipatory medications for the dying patient. Symptom control, including pain, nausea and vomiting, anorexia, constipation, diarrhoea, and breathlessness are also discussed. The chapter focuses not only on the patient and her/his psychological and spiritual needs but also on family members and carers who might also have their own needs. The chapter underlines the importance of communication skills in palliative care and how medical students should observe carefully in either the hospice or in hospital to learn from interactions that are difficult as well as the ones that go well.

An Active In-Home Physician Model of Palliative Care and Its Resulting Performance Indicators Related to Home Deaths, Unplanned Emergency Department Visits and Unplanned Hospital Admissions

2020 ◽  
Vol 36 (1) ◽  
pp. 46-49
Author(s):  
Colleen Webber ◽  
Aurelia Ona Valiulis ◽  
Peter Tanuseputro ◽  
Valerie Schulz ◽  
Tavis Apramian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Hospital Admissions ◽  
Case Series ◽  
Palliative Care Team ◽  
Emergency Department Visits ◽  
Care Team ◽  
Retrospective Case ◽  
Palliative Care Teams ◽  
Unplanned Hospital Admissions

Background: Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams. Case presentation: A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019. Case management: The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization. Case outcomes: In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( n = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( n = 75) patients visited an emergency department and 24.6% ( n = 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively. Conclusion: The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.

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