GP Palliative Care Handover Form. 28 May 2013

Transcription

1 GP Palliative Care Handover Form 28 May 2013

2 Background The IHF/ICGP/IHF Primary Palliative Care in Ireland report published in 2012 Recommendation A from the Primary Palliative Care report: Develop and implement a palliative care summary for communications with out of hour services

3 Background The project has also been informed by research carried out by Dr Fiona Kiely on over 400 GPs in Cork and Kerry which found that: While 82% of GPs do not routinely transfer information pertaining to end-of-life issues to the out-of-hours service, 96% would value a standardised way of transferring information 67% felt they sometimes refer unnecessarily to hospital emergency departments due to lack of information (BMJ Support Palliat Care doi: /bmjspcare )

4 Rationale and objective There is currently no standardised palliative care handover form in use in Ireland Assist GPs in anticipating palliative care needs of their patients (at home or in residential setting) that might arise out side of traditional working hours and communicate these needs in advance to OOH services Improve quality of OOH care, clinical assessment and decision-making

5 Guiding principles Developed from a primary care perspective Orientated towards the needs of all life limiting diseases Introduced as a pilot phase which will have strong evaluation, and quality improvement component Considerate of work streams of HSE clinical care programmes, GPIT group, other work streams from Primary Palliative Care and IHF programmes. Informed by international practice and developments Informed by relevant HIQA, OOH co-operatives, ICGP and HSE guidance Considerate of resource requirements necessary for implementation.

6 What difference will it make? Provide reassurance for patients, family members and professional carers that individual wishes and medical history will be known if patients need care from Out of Hours GPs and improve efficiency of care Patient safety, dignity and wishes are prioritised Provide accurate information on patients palliative care needs can prevent unnecessary emergency admissions to hospital (and avoid needless medical interventions) Could introduce means for GP to set review dates to ensure ongoing reassessment of needs Provide mechanism to ensure that the information required by the OOH is sent / received.

7 How will we know it will make a difference? Contingency planning for emergency care demands OOH No of deaths at home/nursing home recognition of palliative care needs for those with diseases other than cancer anticipatory prescribing No of admissions to acute hospitals No of emergency admissions No of requests to die at home?? access to SPC for advice and referrals from GP and OOH services Take account of experience of family - increased confidence and security re their care OOH (ref uk eval)

8 How will it work? The handover form was developed by a subcommittee of clinical staff, based on an existing form used in NHS Scotland that was adapted according to the language and headings used in the HSE GP referral form Palliative care fields on the form include: symptoms; medications; syringe driver; CPR status; and relevant prognosis Information leaflets for GPs were also developed This form will be faxed from GP to OOH services

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10 SouthDoc Pilot SouthDoc Out of Hours Cooperative (Cork and Kerry)- includes 600 GPs approx December 2012 present Paper document faxed to out of hours (incorporated electronically to HealthOne software) Evaluation will include GP experience in using the form and the palliative care information received by to the OOH service and will inform future GP referral templates. Forms are currently being analysed as part of pre-pilot GOAL: There are approximately 50 calls to SouthDoc a month with a palliative element. The target is that half of these could be anticipated.

11 Thank you