communicating palliative care of needs of patients to out of hours services

Communicating Palliative Care of Needs of Patients to Out Of Hours Services

Irish Cancer Society May 2014

Marie Lynch

Today’s talk

1. Background to work of Irish Hospice Foundation 2. Information on the Primary Palliative Care

Programme 3. Describe the GP →Out of Hours Palliative

Care Handover Form4.

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Death and Dying in Ireland

90% of care in last year of life provided by community based Health care

professionals

2010 Stats

Irish Hospice Foundation

Vision No one should face death or bereavement without the care and support they need Mission Achieve dignity, comfort and choice for all people facing the end of life. We do this by addressing, with our partners and the public, critical matters relating to death, dying and bereavement in Ireland

Information on the IHF

http://vimeo.com/90234575

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Irish Hospice Foundation

IHF Programmes •Primary Palliative Care•Palliative Care for All •Hospice Friendly Hospitals•Bereavement Education and Training•Children's Programme •Forum on End of Life/ Think Ahead•Carers

Education

Grant programmes

Kick start and seed fund

Awareness raising

Advocacy

Primary Palliative Care ProgrammeAIMTo identify palliative care initiatives that will support primary care teams responses to adults with advanced progressive diseases in that live in the community who are expected to die in the next 12 months. ‘Primary care professionals have the potential and ability to provide end of life care for most patients, given adequate training, resources, and, when needed, specialist advice.

They share common values with palliative care specialists - holistic, patient centred care, delivered in the context of families and friends’ S Murray 2004

2011

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GATHERING VIEWS –

186QUESTIONNAIRE

SURVEY RESPONSES

8 Key Themes

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Education Needs

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Guidance Support

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Medication and Equipment Initiatives

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‘Would like to see improved communication with primary

care and hospice team in caring for clients/families at

home ‘

‘Not enough support in

community settings for these

patients’

‘Would love to provide this service but don’t think I have the

necessary skills to do so’

‘The difficulty in accessing all services outside of traditional

working hours for these patients is a problem’

‘Joint consultations

with the palliative care team would

be useful ‘

‘I tend to step back when Palliative Care come

involved…. I have a sense of being disempowered

and de-roled’

PRIORITISED RECOMMENDATIONS

1. Develop and implement a palliative care summary for communication with out of hours services

2. Create a system for primary care teams to identify patients with palliative care needs and respond appropriately.

3. Clarify the extent and means of access to 24 hour SPC advice/information.

4. Provision of information supporting delivery of primary palliative care.

5. Compatibility of medications.

GP→OOH Palliative CareHandover Form

• WHY• WHAT • WHERE & WHEN• HOW

WHY

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Kiely (2013) • 82% of Irish GPs do not routinely hand over information

to the OOH team for patients with palliative care needs • 96% would value a standardised way of transferring

informationWallace (2010)• Admissions to ED of patients in receipt of SPC. 35 Visits

by 30 patients. Source of Referrals Self 40%

On call GP 25.5%

SPC 6%

Timing of referrals

Outside working hours

63%

Sat/Sun 26%

WHYElectronic Palliative Care Summary GPs and OOH NHS Scotland 2009 An independent review

– the majority of GPs using this for cancer patients. – The benefits

• increased reassurance patients and carers; • better informed their decision making OOH teams• assisted in their advance planning with patients. • Recommendations included

– further training in communications and – information technology to support the GPs

in the use of this form.

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WHAT IS IT

• Information transfer system between GPs and their out-of-hours colleagues in relation to patients with palliative care needs

• GPs who may have never met the patient before will have comprehensive clinical information as well as information pertaining to the wishes of the patient

• Patients receive increase – Continuity of care– Safer care

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WHERE & WHEN

SOUTH DOC PILOT• 6 MONTHS April – Sept• 500 GPs• Cork and Kerry • Include residential care

homes

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HOW it WORKS

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1. GP fills out form2. Fax to South Doc3. Details registered on OOH IT system4. If call comes in about patient triage access

information on form available to support continuity of care

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Evaluation

Impact of Service patient careGPsOOH service providersresidential care providers

UsageWhat are the essential information fieldsWhat additional information would helpHow easy is the process

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CONTACT DETAILS FOR QUERIES Marie Lynch01 673 0063

Marie.lynch@hospicefoundation.ie

http://hospicefoundation.ie/

Palliative Care for All

IHF Nurses for Night Care

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IHF Nurses for Night Care referrals 2007 – 2012

Disease Breakdown

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Bereaved.ie

Think Ahead

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CARERS.IE

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