Evaluation of A Novel Information-Sharing Instrument for Home-Based Palliative Care

Abstract

Aim:To examine the feasibility and usefulness of a novel region-based pathway: the Regional Referral Clinical Pathway for Home-Based Palliative Care.Method:This was a feasibility study to evaluate the frequency of variances and the perceived usefulness of pathway using in-depth interviews. All patients with cancer referred to the palliative care team between 2011 and 2013 and received home care services were enrolled.Result:A total of 44 patients were analyzed, and pathway was completed in all the patients. The target outcome was achieved in 61.4% while some variances occurred in 54.5%. Nine categories were identified as the usefulness of the pathway, such as reviewing and sharing information and promoting communication, education, motivation, and relationships.Conclusion:This novel pathway is feasible and seems to be useful.

Going back to home to die: does it make a difference to patient survival?

“…The hospital palliative care consultation team provided regular weekly monitoring, and was available 7 days a week and 24 hours a day on demand. Additionally, information was shared through one pre-discharge multidisciplinary conference and via structured data sheets (information-sharing instruments) [ 13 ]. Visiting physicians, nurses, pharmacists, medical social workers, and other medical staff completed the data sheets with comments for patients and relatives at each visit.…”

Usefulness of a Collaborative Home Visit Program Between Hospital and Visiting Nurses

“…The importance of information sharing has been confirmed in some studies, 10,16 supporting the possibility of promoted communication enhancing nurses' motivation to provide high-quality palliative home care continuously. 10,22 In a study conducted by Osono et al, 14 visiting nurses regarded their sense of burden as a challenge of home medical services for patients with end-stage cancer; such a sense was explained as ''it is physically and mentally burdensome for visiting nurses to provide care on a 24-hour basis'' and ''patients' deaths increase their sense of helplessness,'' with 4 other items, indicating the necessity of preventing night-time home visits by sufficiently managing individual cases during the daytime.…”

“…The contents of discussions during each conference were recorded and shared, using the palliative home care pathway system. 16 The medical social worker adjusted the time of visit, and the visiting nurse and those who had participated in the previsit conference, including the CNS, visited the patient's house on time.…”

“…16 This model is characterized by its particular emphasis on educational objectives. Japan is lacking in medical agencies capable of providing palliative home care.…”

Impact of a Six-Year Project to Enhance the Awareness of Community-Based Palliative Care on the Place of Death

“…To resolve these problems as much as possible and increase the home death rate, we developed and executed a project to enhance the awareness of community-based palliative care (awareness-enhancing project), consisting of three intervention approaches: (1) outreach visits by a hospital palliative care team (PCT) to compensate for insufficient functions in the community using the program (outreach program); (2) palliative care education for community-based medical professionals using an educational program Palliative Care Emphasis Program on Symptom Management and Assessment for Continuous Medical Education (PEACE) 6 , 7 ; and (3) using a newly developed information-sharing tool, Regional Referral Clinical Pathway for Home-based Palliative Care (RRCP-HPC). 8 As the educational program was developed for hospital physicians not specializing in palliative care, its effects on home care physicians and other medical professionals engaged in home care have yet to be clarified.…”