Simultaneous Care clinic (SCC): A three-year monoinstituional experience.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 169-169
Author(s):  
Silvia Stragliotto ◽  
Antonella Brunello ◽  
Sara Galuppo ◽  
Sabina Murgioni ◽  
Vincenzo Dadduzio ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Median Time ◽  
Social Issues ◽  
Home Care Services ◽  
Cancer Type ◽  
Nutritional Evaluation ◽  
Care Clinic ◽  
Oncological Treatment ◽  
Care Services

169 Background: Early palliative care has been shown to improve outcomes in pts with advanced cancer. In accordance with ASCO and AIOM recommendations of implementing palliative care early for pts with metastatic cancer along with active cancer treatment a SCC was set up at Istituto Oncologico Veneto (IOV) in Padova since 2014; Methods: Data of pts referred to the SCC from Mar 2014 to Nov 2016 were retrieved from a prospectively maintained database. Data collected included cancer type, status of disease, PS, ongoing oncological treatment, psychological evaluation, social evaluation, nutritional evaluation, activation of home territorial services and/or Palliative Care services, use of other health services after a first visit and place of death; Results: 533 pts were evaluated by a multidisciplinary team. Overall symptom burden was low with baseline symptom scores highest for fatigue, lack of appetite and depression. Nutritional evaluation revealed 224 pts (42%) with nutritional problems, the most frequent being weight loss (n = 121). Psychological distress was present in 185 pts (35%). Social issues were present in 26 pts (5%) and were dealt with activation of social services (n = 9) or volunteer territorial services (n = 8). Patients deemed in need of home care services after the first access to the SCC were 177 (33%) and for these a formal request for Home Care services activation was sent to the Local Health Territorial Unit. After the first visit 141 patients referred to Emergency Room for intervening problems with median time of 41 days. Globally 290 pts (54%) died with 53% of deaths occurring at home. For pts who were receiving active oncological treatment median time from first-visit in the SCC and death was 126 days. We are also evaluating a score for priority for access to SCC; Conclusions: Early integrated SC may be most effective if targeted to the specific needs of each patient population

Impact of an Oncology Palliative Care Clinic on Access to Home Care Services

2012 ◽  
Vol 30 (5) ◽  
pp. 425-431 ◽  
Author(s):  
Raymond W. Jang ◽  
Debika Burman ◽  
Nadia Swami ◽  
Jennifer Kotler ◽  
Subrata Banerjee ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Home Care Services ◽  
Care Clinic ◽  
Care Services

Active identification of patients appropriate for palliative care: Impact on use of palliative care and home care resources.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 101-101
Author(s):  
Nicole Mittmann ◽  
Ning Liu ◽  
Marnie MacKinnon ◽  
Soo Jin Seung ◽  
Nicole Look Hong ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Service Use ◽  
Intervention Group ◽  
Home Care Services ◽  
Control Group ◽  
Palliative Approach ◽  
Active Identification ◽  
Care Services ◽  
Primary Care Teams

101 Background: This research evaluates whether active identification of patients who may benefit from a palliative approach to care changes the use of palliative care and home care services. Methods: Between 2014 and 2017, Cancer Care Ontario implemented the INTEGRATE project at 4 cancer centres and 4 primary care teams. Physicians in participating sites were encouraged to systematically identify patients who were likely to die within 1 year and would benefit from a palliative approach to care. Patients in the INTEGRATE intervention group were 1:1 matched to non-intervention controls selected from provincial healthcare administrative data based on a publicly funded health system using the propensity score-matching. Palliative care and home care services utilization was evaluated within 1 year after the date of identification (index date), censoring on death, or March 31, 2017, the study end date. Cumulative incidence function was used to estimate the probability of having used care services, with death as a competing event. Rate of service use per 360 patient-days was calculated. Analyses were done separately for palliative care and home care. Results: Of the 1,187 patients in the INTEGRATE project, 1,185 were matched to a control. The intervention and the control groups were well-balanced on demographics, diagnosis, comorbidities, and death status. The probability of using palliative services in the intervention group was 80.3%, which was significantly higher than that in the control group (62.4%) with more palliative care visits in the intervention group [29.7 (95%CI: 29.4 to 30.1] per 360 patient-days) than in the control group [19.6 (95%CI: 19.3 to 19.9) per 360 patient-days]. The intervention group had a greater probability of receiving home care (81.4%) than the control group (55.2%) with more homecare visits per 360 patient-days [64.7 (95%CI: 64.2 to 65.3) vs. 35.3 (95%CI: 34.9 to 35.7)] The intervention group also had higher physician home visits as compared to the control group (36.5% vs. 23.7%). Conclusions: Physicians actively identifying patients that would benefit from palliative care resulted in increased use of palliative care and home care services.

An evaluation of contracted palliative care home care services in Ontario, Canada

2001 ◽  
Vol 24 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Allison M. Williams ◽  
Michelle V. Caron ◽  
Maria McMillan ◽  
Anne Litkowich ◽  
Noreen Rutter ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Care Home ◽  
Home Care Services ◽  
Care Services

scholarly journals Community Nurses’ Preparations for and Challenges in Providing Palliative Home Care: A Qualitative Study

2021 ◽  
Vol 18 (22) ◽  
pp. 11838
Author(s):  
Chien-Yi Wu ◽  
Yu-Hsuan Wu ◽  
Yi-Hui Chang ◽  
Min-Shiow Tsay ◽  
Hung-Cheng Chen ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Critical Role ◽  
Home Care Services ◽  
Structured Interviews ◽  
Community Based ◽  
Palliative Home Care ◽  
Care Services ◽  
Leading Role ◽  
Study Results

Hospitals have played a leading role in providing palliative care in Taiwan as its care model has developed over the past few decades. However, earlier local studies in Taiwan showed that terminal patients prefer to die at home, highlighting the need to promote community-based palliative care instead of hospital-based care. Along with this shift, how community nurses provide palliative home care merits further exploration. This qualitative descriptive study aims to understand (1) how community nurses implement community-based palliative care, (2) what preparations are needed, and (3) what challenges they may face. Purposive sampling was used for recruiting nurses. We conducted one-on-one, in-depth, semi-structured interviews. Interview recordings were transcribed verbatim and analyzed using thematic analysis. Eight community nurses with a range of experience in palliative home care were interviewed. Four major themes emerged: (1) Opportunities, (2) Qualifications, (3) Support, and (4) Commitments. Psychological preparedness, well-developed professional capabilities, external assistance, and peer support motivate community nurses to offer community-based palliative care. As the requests for palliative home care services increase, community nurses play a critical role in palliative home care. Although the sample size is small and the findings retrieved from a small number of experiences might not be generalized to every region, the study results could inform future experience-sharing and workshop sessions to train more nurses for community-based care, expanding service coverage, and providing optimal palliative care.

scholarly journals Sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar: uma revisão integrativa

2021 ◽  
Vol 25 (4) ◽  
Author(s):  
Nair Caroline Cavalcanti de Mendonça Bittencourt ◽  
Karoliny Alves Santos ◽  
Maria Gefé da Rosa Mesquita ◽  
Vanessa Gomes da Silva ◽  
Audrei Castro Telles ◽  
...  
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
Signs And Symptoms ◽  
Home Care Services ◽  
Care Services

Resumo Objetivo identificar os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar. Método revisão integrativa nas bases LILACS, MEDLINE e CINAHL em janeiro de 2020. Perguntou-se: “Quais os principais sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos destacados nos estudos abrangendo o contexto do domicílio?”. Foram descritores/termos: Sinais e Sintomas/Signs and Symptoms; Assistência Domiciliar/Home Care Services; Cuidados Paliativos/Palliative Care e Neoplasias/Neoplasms. Elencaram-se como critérios de elegibilidade: texto completo; entre 2015 e 2019; em inglês, português ou espanhol e idade adulta. Para o mapeamento dos dados, consideraram-se: título; país; ano; objetivo; método; sinais e sintomas. Os resultados foram categorizados em subgrupos, considerando a classificação conceitual predeterminada (sinal e sintoma). O elemento contagem facilitou a análise e a comparação de dados. Resultados foram selecionados 35 artigos, sendo identificados 25 sinais e 23 sintomas. Os mais frequentes foram: dor, náusea/vômito, dispneia, fadiga, depressão, ansiedade, constipação, perda de apetite, sonolência, bem-estar e insônia. A maioria (39) relacionou-se ao domínio físico. Conclusão a identificação dos principais sinais e sintomas, neste contexto, direciona a prática dos profissionais de saúde para as intervenções mais adequadas e o mais precocemente possível, contribuindo para viabilizar a assistência domiciliar, e alerta para a necessidade de educação permanente sobre este tema.

Preplanned participation of paramedics in end-of-life care at home: A retrospective cohort study

2020 ◽  
pp. 026921632098171
Author(s):  
Leena K Surakka ◽  
Minna M Peake ◽  
Minna M Kiljunen ◽  
Pekka Mäntyselkä ◽  
Juho T Lehto
Keyword(s):  
Palliative Care ◽  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Home Care Services ◽  
Life Care ◽  
Care Services ◽  
Care At Home ◽  
Care Ward ◽  
At Home

Background: Paramedics commonly face acute crises of patients in palliative care, but their involvement in end-of-life care is not planned systematically. Aim: To evaluate a protocol for end-of-life care at home including pre-planned integration of paramedics and end-of-life care wards. Design: Paramedic visits to patients in end-of-life care protocol were retrospectively studied. Setting/Participants: All of the patients who had registered for the protocol between 1 March 2015 and 28 February 2017 in North Karelia, Finland, were included in this study. Results: A total of 256 patients were registered for the protocol and 306 visits by paramedic were needed. A need for symptom control (38%) and transportation (29%) were the most common reasons for a visit. Paramedics visited 43% and 70% of the patients in areas with and without 24/7 palliative home care services, respectively ( p < 0.001); while 58% of all the visits were done outside of office hours. Problems were resolved at home in 31% of the visits. The patient was transferred to a pre-planned end-of-life care ward and to an emergency department in 48% and 16% of the cases, respectively. More patients died in end-of-life care wards in areas without (54%) than with (33%) 24/7 home care services ( p = 0.001). Conclusions: Integration of paramedics into end-of-life care at home is reasonable especially in rural areas without 24/7 palliative care services and outside of office hours. The majority of patients can be managed at home or with the help of an end-of-life care ward without an emergency visit.

scholarly journals Organising Home-based Palliative Care Services: A Quality Improvement project at the Homi Bhabha Cancer Hospital and Research Centre, Vishakhapatnam

2021 ◽  
Vol 27 ◽  
pp. 197-203
Author(s):  
Vidya Viswanath ◽  
Leela Digumarti ◽  
Nadimpalli Satyanarayana Raju ◽  
Usha Rani Venkata Lokanandi ◽  
Mohana Rao Dasu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Problem Solving ◽  
Home Care ◽  
Home Care Services ◽  
Quality Improvement Project ◽  
Research Centre ◽  
Improvement Project ◽  
Care Services ◽  
Home Based

Objectives: The key component of a comprehensive palliative care (PC) unit is provision of a regular and sustainable home-based PC (HBPC) service. This quality improvement project aimed to plan, organise and sustain a regular HBPC service in a government cancer centre in Southeast India. The aim was to regularise and increase the number of home care visits among the patients identified for HBPC services through sustainable interventions. Materials and Methods: The A3 methodology with its team-based, structured problem-solving approach was the tool used. The situational process map at baseline was followed up with a sequential cause and effect analysis and team discussions to create sustainable and reliable interventions. These included creating the electronic data system for data collection in PC, allocation of resources and implementation of systems to coordinate HBPC services. The roles and ownership to maintain improvement were established by designation and this requirement has been included in the job description to ensure reliability and sustainability. Results: The regularisation of home care services with a consistent increase in the number of home visits from 2/week to over 6/week helped achieve the Specific, Measurable, Achievable, Relevant and Time bound goal. Better documentation, coordination and accountability were also positive outcomes. Working with different departments and teams along the project helped build trust and understanding along with a sound base for collaborative research. Conclusion: The A3 way of problem solving through dialogue and consensus helped to organise HBPC services and this methodology can be extended to other areas in future.

scholarly journals Patient satisfaction in Home care services through e-Palliative Care -An experience of tertiary cancer centre from Kerala

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Satheesan Balasubramanian ◽  
M. S. Biji ◽  
M. K. Ranjith ◽  
S. S. Abhina
Keyword(s):  
Palliative Care ◽  
Patient Satisfaction ◽  
Home Care ◽  
Descriptive Analysis ◽  
Home Care Services ◽  
Cancer Center ◽  
Care Services ◽  
Level Of Satisfaction ◽  
Stage 4 ◽  
Feasible Option

Objectives: e-palliative care (PC) is an evolving concept wherein technological interface is used to deliver PC to the patients with advanced cancer at their doorstep. This study aims to find out the level of satisfaction of patients receiving e-palliative homecare (e-PHC) service from a tertiary Cancer Center using the validated e-Palliative Patient Satisfaction Questionnaire –Malayalam (PSQM). Materials and Methods: In this prospective study, patients/caregivers on home care were given the e - Palliative PSQM by the homecare nurse after the patient had consulted the doctor through e-PHC service. The questionnaire had 15 statements with response graded using Likert scale. Descriptive analysis was performed to compute the distribution of observed responses to obtain the level of satisfaction among patients or caregivers receiving e-PHC service. Results: This study was done among 120 homecare patients whose median age was 69 (62-79) with almost equal prevalence of both genders. Stage 4 malignancy was seen in 107 (89.2%) patients with the commonest being gastrointestinal malignancy (N=34, 28.3%) The mean score of response for General satisfaction, Technical quality, Communication, Financial aspect, Time spent with doctor and Accessibility and convenience were observed as 4.52, 3.92, 4.48, 4.55, 4.52 and 4.49 respectively. The overall satisfaction was found to be 4.39. Conclusion: The overall satisfaction of patients receiving e-PHC service from our Institution is seen to be high. e- palliative care is a feasible option for providing excellent PC in developing countries with limited resources and financial constraints.

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