Palliative care consultation team on acute wards—an intervention study with pre-post comparisons

Abstract

ᅟThere is little evidence regarding primary healthcare team members’ perceptions concerning palliative care consultation team (PCCT) and palliative care (PC) issues on their own wards.PurposeThis study aimed to study whether a PCCT can influence and change primary healthcare team members’ perceptions regarding the palliative care at the end of life they are providing to patients in their own acute wards.MethodsThe intervention was a PCCT visiting surgical and internal medicine wards in 1 year. We used a quasi-experimental design with pre-post-testing, measuring at baseline, and after 1 year’s intervention. A questionnaire was answered by all primary healthcare team members in three acute wards.ResultsA total of 252 team members (pre-post-intervention n = 132/n = 120) participated in the study. Overall, 11 of the 12 statements scored significantly higher after the intervention than before. Responses varied significantly between different professions and depending on the number of dying patients cared for during the last month. The five with the highest Wald values were as follows: the presence of a break point dialogue with a patient, where the changed aim and focus of care was discussed; early detection of impending death; adequate symptom relief and psychological and existential issues.ConclusionIt is possible to change perceptions about end-of-life care in primary healthcare team members on acute wards. Palliative care consultation teams should be a natural part wherever dying patients are cared for.

Changes in professionals’ beliefs following a palliative care implementation programme at a surgical department: a qualitative evaluation

“…Participants stressed that they had gained an increased awareness of their own professional role and the results reflected beliefs about both strengths and weaknesses in how to manage contacts with patients with palliative care needs, which can be assumed to be a start towards developing a common method of working [ 19 ]. This is also supported by Friedrichsen et al [ 31 ] who reported that professionals’ perceptions in regard to palliative measures could change following implementation of palliative care specialist consultations; to which our study contributes with a suggestion for how beliefs can change.…”

“…Previous implementation of palliative care has shown positive results [ 31 , 35 – 37 ] as was also shown in this study since it was believed that participants felt more confident when their knowledge and their presence seemed to influence patients and their families. However, even after implementation, it was believed that structure and routine were still lacking in the day-to-day work with patients with palliative care needs.…”

“…In a study by McConigley et al [ 40 ] palliative knowledge was seen to change the attitudes of health care professionals and in a study by Friedrichsen et al and Maxwell et al [ 31 , 41 ] such knowledge led to a greater understanding of palliative care. The results of this study revealed a belief that all patients benefit from the integration of a palliative approach into surgical care.…”

Entwicklungen nach Einführung des OPS 8-98h („spezialisierte palliativmedizinische Komplexbehandlung durch einen Palliativdienst“) – eine erste Bilanz Palliativmedizinischer Dienste in Bayern

“…Die Akzeptanz der PMD im eigenen Haus nimmtnach deren eigener Einschätzungweiter zu. Dies deckt sich mit früheren Berichten, die zeigen, dass sich im Krankenhaus tätige Palliativdienste durchgehend gut etablieren, nicht zuletzt aufgrund des Mehrwerts für die Patientenbetreuung, der von den einzelnen Fachabteilungen meist rasch erkannt wird [17][18][19][20]. Auch die tendenziell zunehmende Einbeziehung in Gespräche zu Therapiezieländerungen (▶ Abb.…”

Differences in medical costs for end-of-life patients receiving traditional care and those receiving hospice care: A retrospective study

“…Therefore, National Health Insurance (NHI) developed the Hospice Shared-care Program to improve the rate of hospice care use in Taiwan since 2011, to enable patients who need hospice care to be cared for by hospice care teams in acute wards instead of limiting care to hospice wards. It was hoped that through discussions with hospice teams, the correct knowledge of hospice care could be obtained, and the utilization rate of hospice could be increased [18][19][20].…”