Identifying Factors Affecting Utilization of an Inpatient Palliative Care Service: A Physician Survey

Snow, Caitlin E.; Varela, Benigno R.; Pardi, Desiree A.; Adelman, Ronald D.; Said, Saima; Reid, M. Carrington

doi:10.1089/jpm.2008.0235

Cited by 43 publications

(61 citation statements)

References 14 publications

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“…The PCST was assigned to conduct consultations for both in-and outpatients during the pilot project. The additional provision of a specialized inpatient PC ward was necessary for a large proportion of the patients for whom PCST consultations alone did not suffice [15,28].…”

Section: Recommending Early Integration Of Pc As Standard Of Cancer Carementioning

confidence: 99%

“…Other professionals are afraid of 'discouraging' the patients when requesting a PC consultation [19]. Therefore, the ambiguity of the WHO recommendation might not be specific enough to trigger PC integration as the decision on when to integrate PC remains highly dependent on the primarily treating physician [28]. The negative consequences for holistic and patient-centered cancer therapy have been studied earlier [33,35].…”

Section: Disclosure Statementmentioning

confidence: 99%

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Integrating Palliative Medicine into Comprehensive Breast Cancer Therapy – a Pilot Project

Gaertner

Wuerstlein

et al. 2011

Breast Care

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Background: To comply with the World Health Organization (WHO) recommendations, our institution’s administrative directives were adopted to advocate the provision of palliative care (PC) early in the disease trajectory of breast cancer (BC). To assess the outcome of this recommendation, this study evaluated the effects of this approach. Methods: A retrospective systematic chart analysis of a 2year period was performed. The first PC consultation of patients was analyzed according to (a) physical condition, (b) symptom burden of the patients, and (c) reasons for PC consultation. Results: Many patients were already in a reduced physical state and experienced burdening symptoms when first counselled by PC. After a 1year experience with PC consultations, the number of burdening symptoms identified at first PC consultation decreased and senologists increasingly requested PC support also for nonsomatic issues. Conclusions: A development towards a better understanding of PC competencies after a 1year initiation period could be demonstrated, but BC patients continued to be in late stages of the disease at the time of first PC contact. Diseasespecific guidelines may facilitate and optimize the integration of PC into breast cancer therapy.

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Section: Recommending Early Integration Of Pc As Standard Of Cancer Carementioning

confidence: 99%

Section: Disclosure Statementmentioning

confidence: 99%

Integrating Palliative Medicine into Comprehensive Breast Cancer Therapy – a Pilot Project

Gaertner

Wuerstlein

et al. 2011

Breast Care

View full text Add to dashboard Cite

show abstract

“…By this, it provides a clear algorithm for when to integrate PC. This is necessary since despite factual knowledge many clinicians are still afraid that cancer patients and their relatives might be discouraged after talking to PC professionals [22,23]. Others do not perceive that patients and their families benefit from the early integration of PC structures in their treatment [24].…”

Section: When Should Specialized Pc Be Integrated (Green Flags)?mentioning

confidence: 99%

“…Outpatients can also be cared for by our PC-trained nurses and specialized PC physicians of the outpatient PC team to support general practitioners and home care services. The inpatient PC unit has proved to be an essential component of specialized PC infrastructures in providing adequate support for severely affected patients [22][23][24].…”

Section: What Pc Services Should Be Integrated?mentioning

confidence: 99%

Facilitating Early Integration of Palliative Care into Breast Cancer Therapy. Promoting Disease-Specific Guidelines

et al. 2011

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To comply with patients‘ needs as well as ASCO and WHO recommendations, our institution aims to integrate palliative care (PC) early in the course of breast cancer (BC) therapy. The evaluation of relevant pilot project data revealed that these recommendations were too vague to trigger PC integration. Therefore, a standard operating procedure (SOP) was developed by our interdisciplinary working group to provide disease-specific information to overcome the ambiguity of the WHO recommendations and guide PC integration. Literally, the SOP states that ‘Specialized PC is recommended regularly for all BC patients without curative treatment options, specifically for patients with i) metastasized and inoperable, or ii) locally advanced and inoperable, or iii) relapsing BC, who are receiving intravenous chemotherapy’. This SOP for the first time presents disease-specific guidelines for PC integration into comprehensive BC therapy by defining ‘green flags’ for early integration of PC and delineating PC from senology assignments. Although disease-specific SOPs have also been developed by this working group for other malignancies, the decision when to first integrate PC into BC therapy differs substantially because of the different clinical characteristics of the disease.

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“…[22][23][24][25] The current system of referral relies on primary care doctors, hospitalists, and specialists to provide referral; however, all have been slow to integrate PC into their practices and consistently fail to make appropriate and/or timely referral to PC for their patients. 23,[26][27][28] There are several reasons why PC screening should fall under the purview of ED providers. First, demographic shifts have led to increased use of the ED by patients with advanced chronic illness.…”

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confidence: 99%

Content Validation of a Novel Screening Tool to Identify Emergency Department Patients With Significant Palliative Care Needs

et al. 2015

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Background: The emergency department (ED) is increasingly used by patients with life-limiting illness. These patients are frequently admitted to the hospital, where they suffer from poorly controlled symptoms and are often subjected to marginally effective therapies. Palliative care (PC) has emerged as the specialty that cares for patients with advanced illness. PC has been shown to reduce symptoms, improve quality of life, and decrease resource utilization. Unfortunately, most patients who could benefit from PC are never identified. At present, there exists no validated screening tool to identify significant unmet PC needs among ED patients with life-limiting illness.

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Identifying Factors Affecting Utilization of an Inpatient Palliative Care Service: A Physician Survey

Abstract: Our results suggest possible avenues for building more effective partnerships between palliative care consult services and referring physicians and highlight the need for interventions designed to facilitate physician-patient communication about palliative care.

Cited by 43 publications

References 14 publications

Integrating Palliative Medicine into Comprehensive Breast Cancer Therapy – a Pilot Project

Integrating Palliative Medicine into Comprehensive Breast Cancer Therapy – a Pilot Project

Facilitating Early Integration of Palliative Care into Breast Cancer Therapy. Promoting Disease-Specific Guidelines

Content Validation of a Novel Screening Tool to Identify Emergency Department Patients With Significant Palliative Care Needs

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