Evaluating the California Hospital Initiative in Palliative Services

Pantilat, Steven Z.; Rabow, Michael W.; Citko, Judy; Gunten, Charles F. von; Auerbach, Andrew D.; Ferris, Frank D.

doi:10.1001/archinte.166.2.227

Cited by 14 publications

(12 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the term "consultation service" is not used homogeneously in the context of the palliative care [2,16,17,22,23]. The distribution of diagnosed cancer entities and the high relevance of cancer pain we found is similar to what was reported in other studies [8,23,24], as were the recommendations that were made.…”

Section: Discussionsupporting

confidence: 76%

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

et al. 2014

View full text Add to dashboard Cite

BackgroundA minority of patients with incurable and advanced disease receive specialised palliative care. Specialised palliative care services that complement the care of difficult and complex cases ought to be integrated with services that deliver general care for most patients. A typical setting in which this integrative concept takes place is the hospital setting, where patients suffering from incurable and advanced disease are treated in many different departments.The aim of the study is to investigate the profile and spectrum of a palliative care consultation service (PCCS) at a German university hospital with special reference to pain therapy.MethodsWe retrospectively analysed the PCCS documentation of three years.ResultsMost patients were referred from non-surgical departments, 72% were inpatients, and 28% were outpatients. 98% of the patients suffered from cancer. Counselling in pain therapy was one of the key aspects of the consultation: For 76% of all consulted patients, modifications of the analgesic regimen were recommended, which involved opioids in 96%. Recommendations on breakthrough-pain medication were made for 70% of the patients; this was an opioid in most cases (68%). The most commonly used opioid was morphine. For 17% of the patients, additional diagnostic procedures were recommended. Besides pain management palliative care consultation implied a wide range of recommendations and services: In addition to organising home care infrastructure, palliative care services supported patients and their families in understanding the life-limiting diseases. They also coordinated physical therapy and social and legal advice.ConclusionThis survey clearly shows that for a consultation service to support patients with incurable or advanced disease, a multi-disciplinary approach is necessary to meet the complex requirements of a needs-adapted palliative care in inpatient or outpatient settings. Timely integration of palliative expertise may support symptom control and may give the required advice to patients, their carers, and their families.

show abstract

Section: Discussionsupporting

confidence: 76%

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

et al. 2014

View full text Add to dashboard Cite

show abstract

“…[19][20][21][22][23] To address these problems, hospitals and nursing homes have increasingly developed palliative care consultation teams. [24][25][26][27][28][29][30] Accord-ing to a survey conducted in 2008, 31 31% of all US hospitals now provide some form of palliative care.…”

Section: Arch Intern Med 2011;171(7):649-655mentioning

confidence: 99%

The Optimal Delivery of Palliative Care

Casarett¹,

Johnson²,

Smith³

et al. 2011

Arch Intern Med

View full text Add to dashboard Cite

show abstract

“…There are several descriptions of—and prescriptions for—the development of PCCSs within the hospital setting (1, 6–8). Radwany and colleagues described five strategies that contributed to the development of PCCS: planning, education, communication, accessibility and evaluation (9).…”

Section: Introductionmentioning

confidence: 99%

Navigating Tensions: Integrating Palliative Care Consultation Services Into an Academic Medical Center Setting

Norton

Powers

Schmitt

et al. 2011

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

Context Despite rapid proliferation of hospital-based palliative care consultation services (PCCS) across the country, there is little description of the dynamic processes that the PCCS and the non-PCCS hospital cultures experience during the institutionalization of a successful PCCS. Objectives To describe the institutionalization of a new PCCS in a quaternary care academic medical center (AMC) and highlight two themes, cost and quality, that pervaded the dynamics involved from the inception to the successful integration of the service. Methods Ethnography using longitudinal field observations, in-depth interviews, and the collection of artifacts. The study was performed in a 750-bed quaternary care ACM in the northeastern region of the U.S. Participants were a purposefully selected sample (n = 79) of (a) senior-level institutional administrators, including clinical leaders in nursing, medicine, and social work, (b) clinicians who used the PCCS, either commonly or rarely, and (c) members of the PCCS core and extended teams. Results Key infrastructure components that contributed to the successful integration of the PCCS included: top level interprofessional administrative buy-in to the quality and cost arguments for PCCS, PCCS leadership selection, robust data collection strategies emphasizing quality outcome data, the adoption of the “physician referral only” rule, and incremental and sustainable growth. The PCCS service has grown an average of 23% per year from 2003–2009. Conclusion An in-depth understanding of the dynamic interaction of the infrastructures and processes of a successful institutionalization, in their unique complexity, may help other PCCSs identify and negotiate attributes of their own circumstances that will increase their chances for successful and sustainable implementation.

show abstract

Evaluating the California Hospital Initiative in Palliative Services

Cited by 14 publications

References 9 publications

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

Characteristics of a palliative care consultation service with a focus on pain in a German university hospital

The Optimal Delivery of Palliative Care

Navigating Tensions: Integrating Palliative Care Consultation Services Into an Academic Medical Center Setting

Contact Info

Product

Resources

About