The Development and Evaluation of an Inpatient Palliative Care Admission Triage Tool

Abstract

This study represents the first reported attempt to define the priorities for a waiting list for admission to palliative care units, and demonstrates its utility in providing a transparent process for palliative care units to manage the competing needs of patients referred for care.

Factors Influencing Survival after Discharge from an Australian Palliative Care Unit to Residential Aged Care Facilities: A Retrospective Audit

“…15,30 Several factors may have influenced this finding including the availability of nursing home beds in the region and the increasing demand for inpatient palliative care beds. 3 It is unlikely the difference was due to limitations in homebased community supports as the Barwon region is well served by such services.…”

“…There are numerous reasons for this imbalance including an aging population, 1-3 improved survival for patients with advanced cancers, and the increased involvement of palliative care services in nonmalignant pathologies. 3,4 One consequence of increasing demand has been the requirement for PCUs to offer shorter-duration inpatient care [5][6][7] with attempts made to reduce length of stay. Reith and Lucas 8 proposed that average length of inpatient stay in the United Kingdom should be 10 to 12 days to ensure equitable and efficient palliative care.…”

“…[10][11][12][13][14] Distinction is made between an APCU and the more traditional PCU/hospice on a number of levels including shorter lengths of stay (typically days to 2 weeks), lower inpatient mortality (most < 50%), and an academic mandate for education and research. In Australia although most PCUs continue to provide both short and where necessary longer-term care, this occurs within the context of increasing admission requests 3 and consequent pressure to avoid protracted lengths of stay.…”

Late referral to palliative care consultation service: length of stay and in-hospital mortality outcomes

“…7 Despite the support for palliative care as a key part of oncologic care, it is often underutilized because of fear of patient response, 8 misunderstanding of the role of palliative care, 9,10 and physicians' uncertainty about the appropriate time to refer patients. 11 In response to increasing demand for palliative care, attempts have been made to create policy initiatives and referral triage tools 12 to ensure timely access to palliative care referrals and treatment. [13][14][15] In designing optimal referral policies, hospitals and clinics need to determine which patients to refer as well as the appropriate timing for these referrals, and to design clinical triggers that can help guide these decisions.…”

La durée de séjour en soins palliatifs

“…Des recommandations pour soignants et hôpitaux ont été développées afin de transférer les patients au moment adé quat [1]. Ces recommandations se basent en général non seulement sur des symptômes dif ficiles à contrôler, mais également sur une es pérance de vie restante d'au moins quelques jours afin de permettre au patient hospitalisé de bénéficier des soins spécifiques [2]. Si le patient décède deux ou trois jours après l'admission, l'adap tation au nouveau lieu de soins peut contrebalancer les bénéfices attendus du transfert.…”