Care of the dying in Australia's busiest hospital: benefits of palliative care consultation and methods to enhance access

Journal of Palliative Medicine
Brian Huong Canh Le, James Nicholas Watt

Abstract

Hospital-based palliative care consultative teams assist with decision-making, symptom management, patient and family support, and discharge planning for those with advanced illness. However, there is evidence to suggest that many patients dying within acute hospitals receive no specialist palliative care input. This project aimed to assess care provided to patients dying within a large Australian hospital and to understand senior clinician decision-making around referral to palliative care. A multi-methods approach was taken that incorporated a literature review, a retrospective chart-audit using the Liverpool Care Pathway to assess quality of end-of-life care, and semistructured interviews with clinicians. The audit demonstrated wide variation in referral practices from clinical units, with overall only 42% of dying patients referred. A number of deficiencies in the care of dying patients within the hospital were evident; however, referral for palliative care consultation was associated with improvements in availability of appropriate end-of-life medication orders, communication with patients and families, and cessation of futile treatment and interventions. Eight themes emerged from the interviews with clinicians, including ...Continue Reading

References

Aug 1, 1995·Genitourinary Medicine·D Plummer, V Minichiello
Apr 10, 1997·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·S Førre
Oct 6, 2000·Journal of Pain and Symptom Management·P L ManfrediD E Meier
Oct 10, 2001·Palliative Medicine·H P Dharmasena, K Forbes
Feb 19, 2003·Journal of Pain and Symptom Management·Irene J HigginsonCharles E Normand
Mar 31, 2004·BMJ : British Medical Journal·Valerie Seagroatt, Michael J Goldacre
Aug 10, 2005·Archives of Internal Medicine·F Amos BaileyPatricia S Goode
Aug 15, 2006·Palliative Medicine·Barbara HanrattyAndrea Litva
Oct 14, 2006·Qualitative Health Research·Dana Lee Hansen, Ebba Holme Hansen
Dec 26, 2006·Journal of Palliative Medicine·Ruth L LagmanMellar P Davis
Feb 15, 2007·Journal of Palliative Medicine·Keri L RodriguezRobert M Arnold
May 17, 2007·Internal Medicine Journal·J R HardyUNKNOWN Australian Best Care of the Dying Network, Queensland
Sep 7, 2007·Journal of Palliative Medicine·Brian H C Le, Michael A Ashby
Feb 12, 2008·Journal of Pain and Symptom Management·Laura C HansonStephen Bernard

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Citations

Nov 1, 2012·Neuro-oncology·Esther LinPeter Eastman
Apr 14, 2012·Emergency Medicine International·Roberto ForeroKen Hillman
Nov 23, 2013·American Journal of Respiratory and Critical Care Medicine·May S HuaHannah Wunsch
Nov 26, 2015·American Journal of Respiratory and Critical Care Medicine·Christopher E Cox, J Randall Curtis
Oct 22, 2013·Palliative & Supportive Care·Marissa ArawGisele Wolf-Klein
Mar 25, 2015·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Anne M WilkinsonTapan Rai
Jan 21, 2015·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Holly L NorthamAnita S Mak
May 15, 2013·Palliative Medicine·Jackie RobinsonChristine Ingleton
Nov 2, 2014·The American Journal of Hospice & Palliative Care·Radka BuzgovaDarja Jarosova
Jul 22, 2014·International Journal of Palliative Nursing·Tessa Watts
Dec 15, 2012·BMJ Supportive & Palliative Care·Emma KirbyJon Adams
Apr 11, 2012·Internal Medicine Journal·E D Paratz, E Flynn
Jul 17, 2012·The Medical Journal of Australia·Dell E HoreyAlison F Sands
Jun 11, 2018·BMC Palliative Care·Laurence Jee Peng Leong, Gregory Brian Crawford
Sep 18, 2016·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Maria FriedrichsenAnna Milberg
Jul 15, 2020·International Journal of Nursing Studies·Jan ShepherdJean Ball

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