Therapeutic inertia was present only in about a fifth of patient patients with diabetes being managed by primary care physicians with an interest in diabetes.
Aims and Objectives Although healthcare professionals perceive palliative care as a rewarding humane work, lack of training, leadership and resources are often cited as impediments to deliver high quality palliative care services. Recognising these hurdles and the scope for improvement in palliative care services across Leicester city, the commissioning group, the local hospice (LOROS) and Macmillan Cancer Support collaborated in launching an innovative "Deciding Right" project. This aims to promote identification of patients in their last year of life to provide a timely and robust multidisciplinary care based on the patient's choices. Description of the Project The highlights of the project include developing a local enhanced service (LES), appointing and training of four locality GP mentors to promote awareness, sign-post and support various local health professionals and pathway mapping with multidisciplinary organizations to establish an integrated palliative care services. The service specification of the LES focused on developing and training a palliative care lead GP for each participating practice, timely identification of patients suitable for the care plan, effective discussion with the patients, families and the multidisciplinary team to develop and implement the plan in collaboration, systematic recording of the care plan on the novel, purpose-built and user friendly template on System One, and reflective learning for further development through after-death-audits (ADA). Results and reflections Each practice in the city now has a palliative care lead GP who has received training in identification of patients in their last year of life, communication and care planning. The project achieved improvements in the palliative care register across the city along with paving the pathway to provide an excellence in palliative care through effective communication across multidisciplinary team. It also highlight the need for more comprehensive guidelines for anticipatory prescribing and co-ordination of palliative care in out of hours settings.
BackgroundRecognising the scope for improvement in palliative care services across Leicester city, the commissioning group, the local hospice (LOROS) and Macmillan Cancer Support collaborated in launching an innovative “Deciding Right“ project. The project aims to promote identification of patients in their last year of life to provide a timely and robust multidisciplinary care based on the patient's choices.DescriptionThe project emphasizes on training and education of local health care professionals at various levels. Four locality GP mentors, appointed to facilitate and deliver the objectives of the project, received training at masters level in conjunction with Demon Fort University. The unique collaboration of the commissioning group, local palliative care consultants and Macmillan Cancer Support paved the pathway for the appointed mentors to access training at national level through Macmillan GP support program in addition to locally provided mentoring support from the palliative care consultants. Furthermore, the project also promoted identification of a palliative care lead GP for each participating practice. All lead GPs are given training in identification of patients in their last year of life along with communication skills to conduct effective and timely discussion with the patients and families to develop and implement the mutually agreed palliative care plans in collaboration. The target group for training extended to include sessional GPs and carers from local residential homes to enable them to understand and apply core concepts of palliative care.Results and reflectionsThe project achieved improvements in the palliative care register across the city and paved the path to develop further through implementation of after death audits (ADA). It also highlighted the need for more comprehensive guidelines for anticipatory prescribing. Initial survey of ADA data has shown that most (>90%) of the patients who have care plans achieved their choices including their preferred place of death.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.