Palliative care in the University Hospital Lausanne: from consultations to an integrated regional program

Mazzocato, Claudia; Stiefel, F.; Ducret, S.; Vagnair, André

doi:10.1007/s005200050252

Cited by 5 publications

(6 citation statements)

References 2 publications

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“…From the outset, a strong emphasis was placed on the use of standardised assessment tools, wide-ranging education and research initiatives, and close integration with family physicians to enhance PPC provision. 484,485 These elements of care were similarly emphasized in subsequent reports of successful TPC programs in Lausanne, 486 Milan, 487 Cleveland, 488 Houston, 489 Trondheim, 49 and Toronto, 490 with the latter two also publishing successful randomized controlled trials illustrating the effectiveness of this model of care. 5,49 The model of palliative care at Princess Margaret Cancer Centre serves as one empirical example and is described in Figure 6.…”

Section: Appropriate Palliative Care and Hospice Referralmentioning

confidence: 82%

Integration of oncology and palliative care: a Lancet Oncology Commission

Kaasa

Loge

Aapro

et al. 2018

The Lancet Oncology

577

539

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Presence of palliative care inpatient consultation team Presence of palliative care outpatient clinic Presence of community based / home palliative care Clinical processes (*) Presence of multidisciplinary specialized palliative care team Routine symptom screening in the outpatient oncology clinic Administration of systemic cancer therapy (e.g. chemo and targeted agents) possible in patients admitted to PC service oncology-and palliative care as well as their cultures. Local variations in terms of resources and practices also probably play a role. By acknowledging integration of oncology and PC as a complex process including different parts of the health care system, both horizontally and vertically, and also involving the patient, we propose SCPs as a means for future efforts to promote integration. For the same reasons, this paper will address integration in different panels. Each panel will address different aspects of integration, ranging from how to focus on the patient, to societal changes and new research areas. Introduction of panels Policy-challenges and frameworks Societal challenges Prognostication Patient-centredness-content methodology and clinical implications Models of palliative care integration The role of education: challenges and recommendations Research The commission is an international collaboration between 30 experts in oncology, PC, public health and psycho-oncology. In October 2016 a kick-off meeting was held in Milan where panel leaders were appointed, the structure of the commission was decided, and a plan for the work was agreed upon. During the two following years each panel expanded with experts within the relevant field, conducted topical literature searches, and an interactive writing process was conducted. Both administrative and academic organization were run from Norway, by Stein Kaasa, Jon Håvard Loge and Tonje Lundeby. Policy-challenges and frameworks Questions to be addressed What type of recommendations is given for integration at the national and international level on policy and public health at present? What are the current examples of different practices in organization of palliative care in different national policies in European countries? What kind of policies and approaches are needed for integration of oncology and palliative care? Patient-centredness-content, methodology and clinical implications Questions to be addressed What is patient-centredness? What are the main elements of patient-centred care in practice? How do we involve the family? Communication-a necessary tool for patient-centred care What are the barriers and solutions to succeed? Research Questions to be addressed What are some opportunities and challenges for integrating oncology and palliative care teams to conduct research together? What are some key research priorities related to integration of palliative care and oncology? What are some key research priorities related to symptom assessment and treatment? What are some key research priorities related to psychosocial support, communication and dec...

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Section: Appropriate Palliative Care and Hospice Referralmentioning

confidence: 82%

Integration of oncology and palliative care: a Lancet Oncology Commission

Kaasa

Loge

Aapro

et al. 2018

The Lancet Oncology

577

539

View full text Add to dashboard Cite

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“…In 2009, 59% of National Cancer Institute designated cancer centers and 22% of non‐National Cancer Institute‐designated cancer centers reported having outpatient palliative care clinics in the United States; this proportion has likely grown over time . Several centers have published their experience with freestanding outpatient clinics . In most cases, these clinics have begun as single, one‐half–day clinics per week and have grown quickly with increasing demand .…”

Section: Innovative Models Of Care Deliverymentioning

confidence: 99%

“…89 Several centers have published their experience with freestanding outpatient clinics. [90][91][92][93][94][95] In most cases, these clinics have begun as single, one-half-day clinics per week and have grown quickly with increasing demand. [96][97][98] Large cancer centers, such as The University of Texas MD Anderson Cancer Center and the Princess Margaret Cancer Center, have clinics that operate daily and offer both booked and urgent same-day appointments.…”

Section: Outpatient Clinicsmentioning

confidence: 99%

Improving patient and caregiver outcomes in oncology: Team‐based, timely, and targeted palliative care

Hui

Hannon

Zimmermann

et al. 2018

CA A Cancer J Clinicians

309

272

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Over the past decade, a large body of evidence has accumulated supporting the integration of palliative care into oncology practice for patients with advanced cancer. The question is no longer whether palliative care should be offered, but what is the optimal model of delivery, when is the ideal time to refer, who is in greatest need of a referral, and how much palliative care should oncologists themselves be providing. These questions are particularly relevant given the scarcity of palliative care resources internationally. In this state-of-science review directed at the practicing cancer clinician, we will first discuss the contemporary literature examining the impact of specialist palliative care on various health outcomes. We will then provide conceptual models to support team-based, timely and targeted palliative care. Team-based palliative care allows the interdisciplinary members to address comprehensively the multi-dimensional care needs of patients and their caregivers. Timely palliative care, at its best, is preventative care to minimize crises at the end-of-life. Targeted palliative care involves identifying patients most likely to benefit from specialist palliative care interventions, akin to the concept of targeted cancer therapies. Finally, we will summarize the strengths and weaknesses of innovative care models, such as outpatient clinics, embedded clinics, nurse-led palliative care, primary palliative care provided by oncology teams, and automatic referral. Moving forward, more research is needed to determine how different health systems can best personalize palliative care to provide the right level of intervention, for the right patient, in the right setting, at the right time.

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“…The University Hospital of the Canton of Vaud (CHUV) is a 900-bed university hospital that serves the city of Lausanne and the Canton of Vaud in Switzerland. Since October 1996, the CHUV has had an interdisciplinary palliative consult team (PCT), which receives referrals from units or wards for cancer and non-cancer terminally ill patients (18).…”

Section: Methodsmentioning

confidence: 99%

Referrals of Cancer versus Non-Cancer Patients to A Palliative Care Consult Team: Do They Differ?

et al. 2009

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Rapport de synthèsè, Boris Cantin, Lausanne le 25 mai 20l0 Referrals of cancer versus non-cancer patients to a palliative care consult team : do they differ ? Depuis la fin du XXème siècle, les soins palliatifs se sont développés essentiellement autour de patients souffrant de cancer en phase terminale. Or depuis une dizaine d'années, un nombre croissant d'études rapporte que les patients souffrant de maladies non cancéreuses avancées expérimentent également une variété de problèmes, de dimension physique, psychosociale ou spirituelle. Ces problèmes peuvent avoir un fort impact sur leur qualité de vie. Malheureusement, seule une ~inorité de patients non cancéreux en phase terminale a accès à des soins palliatifs. Le but de cette étude est de mieux comprendre les similitudes et les différences entre les patients cancéreux et non cancéreux lorsqu'ils sont encore hospitalisés dans un hôpital universitaire de soins aigus et réferrés à une équipe mobile de soins palliatifs intrahospitalière. Méthodologie : Dans cette étude rétrospective, les dossiers des 1 OO premiers patients non• cancéreux adres.sés à l'équipe mobile de soins palliatifs (EMSP) ont été comparés avec ceux de 506 patients cancéreux, durant la même période (2000-2001). Nous avons répertorié leurs profils démographiques, les types de demandes des professionnels de 1 ère ligne s'adressant à l'EMSP, les symptômes ainsi que la médication des patients. • Conclusions : Dans les deux groupes de patients, nous. avons retrouvé de manière égale un haut taux de symptômes: 79% de patients non cancéreux et 71% de patients cancéreux expérimentent au moins 3 symptômes ou plus. Cependant, malgré cette similitude en termes d'inconfort, l'équipe de soins palliatifs est appelée plus tardivement pour les patients non cancéreux. Au vu des problèmes de communication verbale chez les patients non cancéreux, les demandes d'évaluation formulées auprès de l'EMSP sont plus orientées vers « une évaluation globale » au lieu d'une aide sur un problème spécifique. Nous retrouvons également une différence en termes d'analgésie entre les deux populations de patients, les patients non cancéreux sont plus fréquemment en surdosage. Selon nos données, un plus grand taux de décès survient à l'hôpital auprès des patients non cancéreux.

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Palliative care in the University Hospital Lausanne: from consultations to an integrated regional program

Cited by 5 publications

References 2 publications

Integration of oncology and palliative care: a Lancet Oncology Commission

Integration of oncology and palliative care: a Lancet Oncology Commission

Improving patient and caregiver outcomes in oncology: Team‐based, timely, and targeted palliative care

Referrals of Cancer versus Non-Cancer Patients to A Palliative Care Consult Team: Do They Differ?

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