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Showing posts with label palliative care. Show all posts
Showing posts with label palliative care. Show all posts

Wednesday, August 13, 2014

A Model to Guide Hospice Palliative Care: based on national principles and norms of practice

The Canadian Hospice Palliative Care Association recently revised the report A Model to Guide Hospice Palliative Care: based on national principles and norms of practice.  Originally released in 2002, the report was intended to provide an example of hospice care that would ensure that all Canadians have access to consistent, high quality care that can relieve suffering and improve quality of life.  The 2013 version has the same intention, however it has been updated to better reflect current practice and experience.
The report has five sections:
1.       The underlying understanding of health and illness
2.        The definition of hospice palliative care and the values, principles and foundational concepts that drive all aspects of hospice palliative care
3.        A guide to the delivery of person and family-centred hospice palliative care to, including a conceptual framework – the “Square of Care” – which identifies:
·         The issues commonly faced by individuals and families during an illness;
·         The essential steps in the process of providing care;
·         The principles and norms of practice related to each step in the process of providing care
4.        A guide to organizational development and function, including a conceptual framework – the “Square of Organization” – which identifies:
·         The resources required to operate a hospice palliative care organization;
·         The principal functions of an organization;
·         The principles and norms of practice related to each aspect of organizational function
5.       Data Collection and Documentation

Wednesday, July 16, 2014

One Chance to Get it Right: Improving people's experience of care in the last few days and hours of life

The Liverpool Care Pathway developed in the 1990’s was a generic model intended to replicate palliative care across settings.  In 2013, the Leadership Alliance for the Care of Dying People (LACDP), a coalition of 21 national organizations, recommended that the United Kingdom phase out the use of the Liverpool Care Pathway in palliative and hospice care by 2014.  It was recommended that generic protocols are not the right approach to caring for individuals in palliative care.  Instead, care should be individualized and reflect the needs and preferences of the dying person.
One Chance to Get it Right outlines the priorities and objects of the newly implemented care pathway.
The new care pathway will focus on achieving five Priorities for Care when it is believed a person will die within the next few days or hours.  These include:
1.       This possibility [of death] is recognized and communicated clearly, decisions made and actions taken in accordance with the person’s needs and wishes, and these are regularly reviewed and decisions revised accordingly.
2.       Sensitive communication takes place between staff and the dying person, and those identified as important to them.
3.       The dying person, and those identified as important to them, are involved in decisions about treatment and care to the extent that the dying person wants.
4.       The needs of families and others identified as import to the dying person are actively explore, respected and met as far as possible.
5.       An individual plan of care, which included food and drink, symptom control and psychological, social and spiritual support, is agreed, coordinated and delivered with compassion.

Wednesday, January 06, 2010

January 2010 Issue of Health Affairs Looks at Palliative Care in Nursing Homes

From the Center to Advance Palliative Care e-News:

This month's issue of Health Affairs, the leading journal of health policy thought and research, focuses on long-term care services. Two articles look specifically at palliative care and end-of-life care in nursing homes:

"Raising the Standard: Palliative Care in Nursing Homes" by Diane E. Meier, Betty Lim, and Melissa D.A. Carlson. Health Affairs, 29, no. 1 (2010): 136-140.

"A New Medicare End-Of-Life Benefit For Nursing Home Residents" by Haiden A. Huskamp, David G. Stevenson, Michael E. Chernew, and Joseph P. Newhouse. Health Affairs, 29, no. 1 (2010): 130-135.



Readers may also be interested in: Adler ED, Goldfinger JZ, Kalman J, Park ME, Meier DE. Palliative care in the treatment of advanced heart failure. Circulation 2009; 120:2597-606.

Monday, June 08, 2009

Better Care Every Step of the Way: Report on the Quality of Palliative and End of Life Care

Published by the Scottish Commission for the Regulation of Care in April 2009, this report details what the Healthcare Regulation Care Commission found out about palliative and end of life care from their inspections; and what they learned from complaints about palliative and end of life care in care homes.

http://www.carecommission.com/images/stories/documents/publications/reviewsofqualitycare/better_care_every_step_of_the_way_-_april_2009.pdf

Thursday, October 23, 2008

Policies and Tools for Hospital Palliative Care Programs

From the Center to Advance Palliative Care, (Mount Sinai School of Medicine) this document pulls together preferred practices, tools, web resources, training resources, and family education materials for providing quality palliative care in hospital.

In 2006, the National Quality Forum (NQF) issued a report detailing 38 Preferred Practices for Palliative and Hospice Care Quality. NQF used the Clinical Practice Guidelines for Quality Palliative Care as the starting point for developing Preferred Practices

The Center to Advance Palliative Care (CAPC) has developed a document that provides a crosswalk between The Joint Commission standards and palliative care. This document will assist programs in developing the necessary policies and associated clinical tools and resources to ensure that a palliative care program meets the NQF’s Preferred Practices. This document is divided into three sections:

I. Index of Preferred Practices, Policies, Tools and Resources

II. Sample Policies developed by existing hospital-based palliative care programs.
Hospitals can adapt these tools to fit their institutions’ needs.

III. Tools/Resources to implement the Preferred Practices. Hospitals can adapt these
tools to fit their institutions’ needs.

http://www.capc.org/support-from-capc/capc_publications/nqf-crosswalk.pdf

Improving Palliative Care in Nursing Homes

In August 2006, the Fan Fox and Leslie R. Samuels Foundation (the Foundation) awarded the Center to Advance Palliative Care (CAPC) a planning grant to develop strategies for providing palliative care in nursing home settings. The purpose of the planning grant was three-fold:

1) Assess the need for palliative care in the nursing home setting;
2) Evaluate effective approaches to meeting the need; and
3) Develop a practical strategy for extending palliative care services to nursing home
residents.

This report to the Foundation reviews the needs assessment conducted by project researchers and describes our findings. The need for extending palliative care services to nursing facilities is compelling, and the report includes suggestions for future initiatives in this area.

http://www.capc.org/support-from-capc/capc_publications/nursing_home_report.pdf

Monday, May 12, 2008

Improving Care at End of Life

This paper from the King's Fund (UK) provides a descriptive analysis of the impact and costs of new services as part of the Marie Curie Delivering Choice Programme, which was launched in 2004.

Delivery of care for patients at the end of their lives is becoming an increasing policy concern. Although the majority of people report that they would choose to die in their home, only a minority of patients achieve this wish. The Delivering Choice Programme aims to develop and help provide the best possible service for patients at the end of their lives.

http://www.kingsfund.org.uk/publications/kings_fund_publications/improving_choice_at.html

Monday, March 31, 2008

Palliative Care Guideline from the American College of Physicians

Evidence-based interventions to improve the palliative care of pain, dyspnea, and depression at the end of life: a clinical practice guideline from the American College of Physicians. Ann Intern Med 2008 Jan 15;148(2):141-6. PubMed

Monday, February 04, 2008

Palliative Care/Hospice for Persons with Terminal and/or Chronic Progressive Illness

From Brown University, Center for Gerontology and Health Care Research, this report examines the quality and amount of palliative care for the estimated 10 million Americans with long-term care needs.

The researchers highlight important opportunities to improve the quality of care for
frail, older persons dying of chronic progressive illness.

This study’s intent was to expand the understanding of how state policies/practices influence access to and quality of palliative care/hospice for persons needing long-term care services, in order to clarify the advocacy and research needed to better inform policy debates as well as state long-term care initiatives.

Interviews with stakeholder groups and long-term care and state policy experts provided researchers with multiple perspectives on the issues and aided in our identification of policy concerns.

http://www.chcr.brown.edu/PDFS/JEHT_4_FINALREPORT07.PDF