A simplified screening tool to identify seriously ill patients in the Emergency Department for referral to a palliative care team

2017 ◽  
Vol 83 (5) ◽  
Author(s):  
Paolo Cotogni ◽  
Anna De Luca ◽  
Andrea Evangelista ◽  
Claudia Filippini ◽  
Renata Gili ◽  
...  
2020 ◽  
Vol 36 (1) ◽  
pp. 46-49
Author(s):  
Colleen Webber ◽  
Aurelia Ona Valiulis ◽  
Peter Tanuseputro ◽  
Valerie Schulz ◽  
Tavis Apramian ◽  
...  

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.


2017 ◽  
Vol 34 (10) ◽  
pp. 984-990 ◽  
Author(s):  
Emilie Green ◽  
Sarah Ward ◽  
Will Brierley ◽  
Ben Riley ◽  
Henna Sattar ◽  
...  

Background: Patients with palliative care needs frequently attend the emergency department (ED). There is no international agreement on which patients are best cared for in the ED, compared to the primary care setting or direct admission to the hospital. This article presents the quantitative phase of a mixed-methods service evaluation, exploring the reasons why patients with palliative care needs present to the ED. Methods: This is a single-center, observational study including all patients under the care of a specialist palliative care team who presented to the ED over a 10-week period. Demographic and clinical data were collected from electronic health records. Results: A total of 105 patients made 112 presentations to the ED. The 2 most common presenting complaints were shortness of breath (35%) and pain (28%). Eighty-three percent of presentations required care in the ED according to a priori defined criteria. They either underwent urgent investigation or received immediate interventions that could not be delivered in another setting, were referred by a health-care professional, or were admitted. Conclusions: Findings challenge the misconception that patients known to a palliative care team should be cared for outside the ED. The importance and necessity of the ED for patients in their last years of life has been highlighted, specifically in terms of managing acute, unpredictable crises. Future service provision should not be based solely on a patient’s presenting complaint. Further qualitative research exploring patient perspective is required in order to explore the decision-making process that leads patients with palliative care needs to the ED.


2021 ◽  
Vol 10 (3) ◽  
pp. 57-64
Author(s):  
Lindy Grief Davidson

Conducting research in a familiar site of crisis brings about feelings of resonance between a researcher and participants. After 11 months of shadowing a pediatric palliative care team and 20 interviews with parents and grandparents of seriously ill children, the author, also the parent of a medically complex child, searched for creative ways to explore her findings. In this exploration of life as the parent of a seriously ill hospitalized child, the researcher reflects on her participants’ and her own collective experiences and frustrations in the form of poetry.


Author(s):  
Deborah Witt Sherman ◽  
David C. Free

Nurses, who are educated in palliative care nursing, facilitate the caring process through a combination of science, presence, openness, compassion, mindful attention to detail, and teamwork. As members of the interdisciplinary palliative care team, nurses bring specialized competence and expertise gained through education, credentialing, and experience. With close to 19.4 million nurses globally, nurses have a tremendous potential to reform health care and ensure quality care for seriously ill patients and their families. Through the integration of empirical, aesthetic, personal, and ethical knowledge at the generalist or advance practice levels, nurses reshape societal perspectives regarding illness, dying, and death. By virtue of their numbers, experience, education, time spent at the bedside, and insight into the lived experiences of patients and families, nurses have the potential to play a prominent role in as public health advocates for palliative care at the local, national, and global level.


2015 ◽  
Vol 10 (2) ◽  
pp. 901-905
Author(s):  
Hiroyuki Watanabe ◽  
Miwako Eto ◽  
Keiichi Yamasaki

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