Palliative Care Referral/Triage Tool
|
|
- Juniper Atkins
- 6 years ago
- Views:
Transcription
1 Palliative Care Referral/Triage Tool Gippsland Region Palliative Care Consortium Clinical Practice Group Title Keywords Ratified Palliative Care Referral/Triage Tool Palliative Care, triage, symptom assessment, PCOC definitions, clinical indicators GRPCC Clinical Practice Group Effective Date March 2015 Review Date Purpose Every two years from effective date The intent of this document is to assist nurses in gathering relevant and up to date clinical information to identify appropriateness of the palliative care referral based on best practice. Enquiries can be directed to GRPCC by or phone Acknowledgement Some of the information contained in this document was taken from Latrobe Community Health Service Referral form, the Gold Standards Framework Centre and the palliative care DRAFT triage tool Palliative Care Clinical Network, Department of Health, State Government Victoria. Pages 11 This document is Copyright Gippsland Region Palliative Care Consortium. Please seek permission before modifying and/or reproducing this document Copyright 1
2 1. Background 2. Purpose It is widely acknowledged there have been inconsistencies among palliative care services state-wide on the content and style of referral forms. In an effort to streamline processes and to assist clinicians in effective palliative care triage the Victorian Department of Health developed and introduced the Service Coordination Tool Templates (SCTT) to facilitate and support palliative care service coordination. 1 The SCTT provides a suite of templates that support the collection and recording of initial contact, initial needs identification, referral and coordinated care planning information in a standardised way. This set of tools however does not provide scope to effectively triage the appropriateness of the referral and timely admission of clients into a palliative care program. In February 2012, the Victorian Department of Health Palliative Care Clinical Network (PCCN) established a triage working group to: explore and coordinate the work related to triage processes in palliative care services, as there is no unified approach in Victoria; and make recommendations to the PCCN to promote consistency of practice across the state. 2 The final recommendation from this working group proposed that further work is required to establish validity and reliability of the tool in different settings plus ongoing funding is required for this substantial piece of work. 3 The Gippsland Region Palliative Care Consortium Clinical Practice Group (GRPCC CPG) has developed a palliative care referral/ triage tool to assist clinicians in effective decision making to ascertain appropriateness of referrals. This tool incorporates a suite of Appendices grounded on the Palliative Care Outcomes Collaboration (PCOC) standardised palliative care language, definitions and clinical assessment tools that measure and assist clinicians in benchmarking client outcomes in palliative care. The PCOC assessment tools meet the Palliative Care Australia (PCA) Standards for Providing Quality Palliative Care for all Australians. 4 The suite of Appendices incorporates: 1 PCOC language, tables, assessment tools and definitions; 5 2 core triage elements of the PCCN Triage tool; 6 and 3 specific clinical indicators to assist clinicians with effective referral/triage processes pertaining to malignancies, non-malignancies and neurodegenerative conditions. 7 The main objectives of the GRPCC CPG Palliative Care Referral/Triage Tool are to: ensure consistency and adherence with the Department of Health directions; 8 promote equity of access; facilitate timely admission into a subregional palliative care service/program for clients with advanced/progressive disease; identify those clients who will benefit from specialised palliative care and consultancy; 9 ascertain and obtain relevant clinical information related to client s progressive disease; and Copyright 2
3 assist referral sources and services to: effectively determine appropriateness of the referral; ascertain degree of urgency; and ensure timely admission. The Victorian Department of Health Strengthening palliative care: Policy and strategic directions outlines the strategic directions that will improve care for Victorians with a life-threatening illness, their families and carers. The strategic directions are: informing and involving clients and carers caring for carers working together to ensure people die in their place of choice providing specialist care when and where is needed coordinating care across settings providing quality care supported by evidence ensuring support from communities. Strategic direction 4: providing specialist palliative care when and where it is needed provides evidence that early/timely referral to palliative care has been demonstrated to significantly improve clients quality of life and mood and to improve their survival time. Strategic direction 5: coordinating care across settings aims to ensure that effective service coordination is important for palliative care clients and their carers whose time-critical and rapidly changing needs are best met by services communicating and working together. Strategic direction 6: providing palliative care supported by evidence stipulates that implementing clinical guidelines, protocols and tools facilitates improvements in client care, for example: timely referrals to palliative care; reduced admissions to the emergency department; decreased length of stay in hospital; and increase in the proportion of deaths at home in a non-acute care facility. 2.1 Criteria for admission Referral to a palliative care service / program depends on the service and organisational structure. However well-known and accepted components apply to most of the referral/ admission criteria. These include: 1 The client has a progressive life limiting illness for which the primary goal is maximising function and comfort 2 The client and /or family is aware of the diagnosis and prognosis and the referral has been discussed and agreed with client and family 3 The referral is discussed and negotiated with the primary health professional 4 The client/caregiver and family have identified needs that are not being adequately addressed Copyright 3
4 2.2 Assessment to ascertain appropriateness of the referral There is consensus that referrals should be responded to in a timely manner i.e. within hours upon receipt of referral. Effective response to referrals can be achieved through effective triage and gathering of relevant and timely clinical information including reasons for referral. There are important clinical elements to be identified by referral sources and services, which can assist to determine the referral s degree of urgency and client s symptom acuity. These clinical elements would include: physical and/or psychological symptoms causing distress that are not responding to current management interventions; increased risk of complexity of symptom/s and complicated grief; and client s condition is deteriorating rapidly. 2.3 Transfer of care Clients needs change overtime. There will be a proportion of admitted palliative care clients across the sub-regions who no longer require palliative care support. These clients and their caregivers, when pertinent, will be reassessed and then discharged if their condition stabilises. For this to occur palliative care services must ensure effective referral processes to primary care providers to promote smooth transition and scope to re-admit if and when this may be necessary. The following clinical information is to be obtained from clients who may be discharged from the palliative care program: recent investigations (scans, blood tests, imaging) reveal stable disease; known positive response to treatment (medical consultant corroborate that client is in remission); disease is still evident but only progressing slowly with no significant changes to the client s functional status (condition has been stable over a period of time i.e. 3 months); client s symptoms have improved significantly and are being managed without continued palliative care intervention; palliative care reassessment identifies that client and caregiver needs can be more appropriately met by a generalist service; the client is competent to make decisions and request no further input from the palliative care program and the caregiver, if relevant, agrees; and the client moves away from the catchment area. 9, 10 Copyright 4
5 Palliative Care Service Referral/Triage Form Page 1 of 2 Patient name Date of Birth Gender Male Female Home address Phone home Phone mobile Patient living alone Yes No GP name and phone Main carer Address (if different to patient address) Available home visits Yes No Contactable by phone after-hours Relationship Phone Yes No If main carer and next of kin are not the same, please add comments in page 2 Referral for: Community based service Inpatient unit / hospital admission Residential Aged Care Facility consultation Other Urgency of Referral: Assessment and/or admission requested within 24 hours; (urgent; patient unstable, rapidly deteriorating or in the terminal/dying phase) Two working days; (patient experiencing distressing physical and/or psychosocial symptoms not responding to established palliative care management/ protocols) One week; (patient is stable but seeking palliative care information and support) Pending; (patient has not yet consented to palliative care referral and/or is an inpatient) Please tick if applicable Specific geographical requirements; patient lives alone in remote area and/or is isolated Main diagnosis, treatment to date, further treatment planned; e.g. recent admission(s), radiotherapy, chemotherapy Reasons for referral Active problems/distressing symptoms Other relevant medical conditions and/or infection control issues Please attach copies of recent medical correspondence, recent screening/imaging and blood results Copyright 5
6 Palliative Care Service Referral/Triage Form Page 2 of 2 Patient N a m e : Date of Birth: Current medications and significant recent changes Known allergies/drug side effects Estimated prognosis Tick one of the following: Days Weeks Months Awareness of diagnosis / prognosis / referral to palliative care Tick as appropriate Patient Family/Carer Diagnosis Yes No Yes No Prognosis Yes No Yes No Referral Yes No Yes No Any other relevant information (include family issues/dynamics, cultural needs, carer s anxiety, other contact details, or health professionals involved, Advance Care Plan / Medical Enduring Power of Attorney) Problem Severity Score 5 Clinician rated 0=Absent, 1=Mild, 2=Moderate, 3=Severe Please apply number to relevant symptom/s: Difficulty sleeping: Appetite problems: Nausea: Bowel problems: Breathing problems: Fatigue: Pain: Psychological / Spiritual: Family / Carer: Other: Phase of Illness 5 (Tick one) Phase 1: Stable Phase 2: Unstable Phase 3: Deteriorating Phase 4: Terminal Phase 5: Bereaved Karnofsky Performance Scale Score 5 Referred by: Nurse Consultant Hospital Community Health Centre Family member Other Name: Organisation: Phone: Nurse taking referral Signature: Date: Copyright 6
7 Appendix 1 5 Phase Definitions The Palliative care phase is the stage of the patient s illness. Palliative care phases are not sequential and a patient may move back and forth between phases. Palliative care phases provide a clinical indication of the level of care required and have shown to correlate strongly with survival within longitudinal prospective studies. PALLIATIVE CARE Summary of Criteria for Referral people of all ages who are in the last stages of advanced illness for which there is no possibility of cure (this may be over weeks or months); people who have had a recurrence or worsening of symptoms within the framework of a life limiting illness; individuals with a life limiting illness that are experiencing symptom distress despite established palliative care management and protocols; individuals who have consented to being referred to the services and; individuals who are aware of their diagnosis and their prognosis (life expectancy). PALLIATIVE CARE PHASE OF ILLNESS Clinician rated 1. STABLE Symptoms are adequately controlled by established management 2. UNSTABLE Development of a new problem or a rapid increase in the severity of existing problems 3. DETERIORATING Gradual worsening of existing symptoms or the development of new but expected problems 4. TERMINAL Death likely in a matter of days 5. BEREAVED Death of a patient has occurred and the carers are grieving Refer to complete Phase Definitions AKPS Triggers that may guide expeditious referral to specialist palliative care (if client falls within more than two of these categories): Karnofsky below 50 Phase of care: unstable/deteriorating or terminal Frequent presentations to acute care Frequent inpatient palliative care admission Complex symptoms shown to have been refractory to various treatment modalities Complex care needs- difficult family dynamics Home death request Facilitation of end of life care decision making and choices Unmet psychosocial needs requiring allied care support Anticipated loss and grief issues (known past loss and grief experiences that anticipates poor bereavement outcome) Patient/caregiver/family experiencing difficulties accepting the realities of advanced disease prognosis. Australian modified Karnofsky Performance Scale Clinician rated 100 Normal, no complaints or evidence of disease 90 Able to carry on normal activity, minor signs or activity 80 Normal activity with effort, some signs or symptoms of disease 70 Care for self, unable to carry on normal activity or to do active work 60 Occasional assistance but is able to care for most needs 50 Requires considerable assistance and frequent medical care 40 In bed more than 50% of the time 30 Almost completely bedfast 20 Totally bedfast & requiring nursing care by professionals and/or family 10 Comatose, barely rousable Copyright 7
8 Appendix 2 As obtained from the Palliative Care Clinical Network 6 Core triage elements: the core elements included in the tables below, at a minimum, necessary for the triage process in community and inpatient services. Core elements Date Staff initial Week 1 Week 2 Phase of care Stable = 0, Unstable = 3, Deteriorating = 1, Terminal = 3 Karnofsky < 60 = 1 Daily palliative care clinical requirements Yes = 3 May include, but not limited to, and maybe a combination of these: Syringe driver Specific palliative care issues e.g. risk of or established spinal cord compression Education to client/caregiver to manage care e.g. clexane, colostomy to enable client to get home until they feel confident to manage care independently. Potential for catastrophic event Yes = 1 For example: Catastrophic bleed Acute respiratory obstruction Major seizures Care environment No = 3 Partial = 1 Consider: carer availability, geography/ location and GP and other health services support and availability (i.e. nursing home, boarding house, SRS) Problem severity score (severe=3, moderate=2, mild=1) Pain Other symptoms Psychological/spiritual Family or caregiver Time on waiting list 3 6 Total triage score Maximum = 23 (excluding waiting list score) Triage completed by (name and date) Recommended action > 10 = Category A (24-48 hrs.) 6-9 = Category B ( 2-5 days) < 6 = Category C (6-10 days) Category D = not yet ready for assessment Copyright 8
9 Appendix 3 Specific clinical indicators to assist clinicians with effective referral / triage processes flexible criteria with some overlaps especially for those with frailty and other comorbidities 7 The surprise question for patients with advanced disease of progressive life limiting conditions Would you be surprised if the patient were to die in the next few months, weeks, days? The answer to this question should be an intuitive one, pulling together a range of clinical, co morbidities, social, existential and other factors that give the whole picture of deterioration. If you would not be surprised, then what measures might be taken to maintain/improve patient s quality of life and comfort now and in preparation for further decline and the terminal phase? a) Cancer rapid or predictable decline Metastatic cancer The single most important predictor in cancer is performance status and functional ability if patients are spending more than 50% of their time in bed/lying down, prognosis is estimated to be about three months or less. b) Organ failure erratic decline Heart Disease At least two of the indicators below: CHF shortness of breath on minimal exertion Patient thought to be in the last year of life by the care team The surprise question Repeated hospital admissions with heart failure symptoms Difficult to manage physical and psychological symptoms despite optimal tolerated therapy. Chronic Obstructive Pulmonary Disease (COPD) At least two of the indicators below: Disease assessed to be severe (e.g.fev1<30% predicted) Recurrent hospital admissions (at least three in the last 12 months due to COPD) Fulfils long term oxygen therapy criteria Dyspnoea symptom score 4/5 after short ambulation or at rest Signs and symptoms of right heart failure Other associated factors i.e. anorexia, recurrent chest infections More than six weeks of systemic steroids for COPD in preceding six months Copyright 9
10 Renal Disease End Stage Kidney Disease whose condition is deteriorating: Patient for whom the surprise question is applicable Patient has chosen the no dialysis option, has discontinued dialysis or not opting for dialysis if transplant has failed Patients with difficult physical and/or psychosocial symptoms despite optimally tolerated renal replacement therapy Symptomatic renal failure nausea and vomiting, anorexia, reduced functional status, intractable fluid overload, etc. Neurological Diseases Progressive deterioration in physical and/or cognitive function despite optimal therapy Symptoms are complex and difficult to manage Swallowing difficulties (dysphagia) leading to recurrent aspiration pneumonia, sepsis, distressing breathlessness and respiratory failure Speech problems: increasing difficulty in communication and progressive dysphasia. Plus the following: Motor Neurone Disease Marked rapid decline in functional status Recurrent episodes of aspiration pneumonia Increased cognitive dysfunction Weight loss Complex symptoms Communication difficulties Impaired mobility (dyskinesia) and falls Parkinson s Disease Drug therapy (often complex) becoming increasingly ineffective Marked reduction in functional status, requiring increasing assistance with ADLs Dyskinesias, mobility problems and falls Emergence of psychiatric signs and symptoms (depression, anxiety, hallucinations) Difficult to manage physical and psychological symptoms despite optimal tolerated therapy Multiple Sclerosis Significant complex symptoms and medical complications Dysphagia + poor nutritional status Communication difficulties e.g. dysarthria, myopathies + fatigue Increasing cognitive impairment; onset of dementia c) Frailty / Dementia - gradual decline Frailty Multiple co morbidities associated with significant impairment in functional status Karnofsky of 50 or less. Combination of at least three of the following symptoms: weakness low speed walking significant weight loss severe fatigue/exhaustion low physical activity depression Dementia There are many underlying conditions which may lead to degrees of dementia. Triggers to consider that indicate that someone is entering the late stages of dementia are: unable to walk without assistance urinary and faecal incontinence unable to carry on ADLs independently and unable to engage in consistent meaningful conversation. Plus any of the following: weight loss recurrent urinary tract infection recurrent fevers severe pressure sores Copyright 10
11 References 1. Victorian Department of Health, 2012, Service Coordination Tool Templates 2. Victorian Department of Health, Palliative Care Clinical Network; PCCN workplan / strategy Palliative+Care+Clinical+Network+-+Summary+of+the+Implementation+Pla n+for+2012.pdf 3. Chair Triage Working Group Palliative Care Clinical Network, Victorian Department of Health, May 2013, professional communication 4. Palliative Care Australia, 2005, Standards for Providing Quality Care for all Australians providing%20quality%20palliative%20care%20for%20all%20australians.pdf 5. University of Wollongong, Palliative Care Outcomes Collaboration 6. Victorian Department of Health, Palliative Care Clinical Network 7. The Gold Standards Framework Centre in End of Life, 4th edition 2011,Prognostic Indicator Guidance 8. Victorian Department of Health, 2011, Strengthening palliative care: Policy and strategic directions Loddon Mallee Regional Palliative Care Consortium, May 2011, Timely specialist palliative care service assessment and support guidelines 10. Melbourne City Mission Palliative Care 2012, Separation and Discharge Policy and Procedure Copyright 11
Three triggers that suggest that patients could benefit from a hospice palliative care approach
Why is it important to identify people nearing the end of life? About 1% of the population dies each year. Although some deaths are unexpected, many more in fact can be predicted. This is inherently difficult,
More informationTRAJECTORY OF ILLNESS IN END OF LIFE CARE
TRAJECTORY OF ILLNESS IN END OF LIFE CARE By Dr Helen Fryer OBJECTIVES To be aware of the three commonest trajectories of decline in the UK To understand the challenges faced in delivering effective Palliative
More informationDefinitions in Palliative Care
Definitions in Palliative Care Palliative care is specialist care provided for all people living with, and dying from a terminal condition and for whom the primary goal is quality of life. Palliative Care
More informationCommunity and Mental Health Services. Palliative Care. Criteria and
Community and Mental Health Services Specialist Palliative Care Service Referral Criteria and Guidance November 2018 Specialist Palliative Care Service Referrals These guidelines cover referrals for patients
More informationSpecialist Palliative Care Referral for Patients
Specialist Palliative Care Referral for Patients This guideline covers referrals for patients with progressive terminal illness, whether due to cancer or other disease. For many patients in the late stages
More informationSpecialist Palliative Care Service Referral Criteria and Guidance
Specialist Palliative Care Service Referral Criteria and Guidance Specialist Palliative Care Service Referrals These guidelines cover referrals for patients with progressive terminal illness, whether
More informationPatient Outcomes in Palliative Care
South Australia Patient Outcomes in Palliative Care January June 2014 Report 17 September 2014 PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au
More informationGUIDELINES: Referral Guidelines to Nelson Tasman Hospice Service including Clinical Criteria for Patients
GUIDELINES: Referral Guidelines to Nelson Tasman Hospice Service including Clinical Criteria for Patients Overview Admission to the hospice service is NOT diagnosis specific and includes all patients with
More informationPatient Outcomes in Palliative Care for South Australia
Patient Outcomes in Palliative Care for South Australia July to December 215 PCOC is a national palliative care project funded by the Australian Government Department of Health The Palliative Care Outcomes
More informationSymptoms Assess symptoms and needs across all domains. Screen using Edmonton Symptom Assessment System (ESAS) for: Pain Nausea Depression
A Palliative Care Approach for Primary Care Integrating a palliative care approach earlier in the disease trajectory improves the quality of living and dying, and relieves suffering for patients and families
More informationPatient Outcomes in Palliative Care
Queensland Patient Outcomes in Palliative Care July December 2013 Report 16 March 2014 PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au
More informationCareFirst Hospice. Health care for the end of life. CareFirst
Hospice Health care for the end of life 1 What is Hospice? Hospice is a philosophy- When a person in end stages of an illness can no longer receive, or wants to receive, life sustaining treatment, he or
More informationDelivering personalised care to end of life patients. Jane Naismith Nurse Consultant in Palliative care St Joseph s Hospice London
Delivering personalised care to end of life patients Jane Naismith Nurse Consultant in Palliative care St Joseph s Hospice London Over View This session will cover Supporting patients with long term conditions
More informationPatient Outcomes in Palliative Care for Victoria
Patient Outcomes in Palliative Care for Victoria July to December 215 PCOC is a national palliative care project funded by the Australian Government Department of Health The Palliative Care Outcomes Collaboration
More informationCase studies: palliative care in Vital Signs 2014: The State of Safety and Quality in Australian Health Care
University of Wollongong Research Online Australian Health Services Research Institute Faculty of Business 2014 Case studies: palliative care in Vital Signs 2014: The State of Safety and Quality in Australian
More informationThe structure of PCOC involves three levels. Definitions for each level can be found in this manual. Level 1: Patient level describes demographics
The PCOC Structure The standardisation of palliative care clinical data items and assessment tools serves the dual purpose of defining a common language to enhance communication between palliative care
More informationVictoria: patient outcomes in palliative care: January - June 2014: report 17
University of Wollongong Research Online Australian Health Services Research Institute Faculty of Business 2014 Victoria: patient outcomes in palliative care: January - June 2014: report 17 Alanna M. Holloway
More informationPatient Outcomes in Palliative Care
Victoria Patient Outcomes in Palliative Care January June 2013 Report 15 25 th October 2013 PCOC is funded under the National Palliative Care Program and is supported by the Australian Government Department
More informationPalliative Care Outcomes Collaboration. Clinical Manual
Palliative Care Outcomes Collaboration Clinical Manual Table of Contents Introduction to this Manual... 5 The Palliative Care Outcomes Collaboration Program... 4 The PCOC Structure... Error! Bookmark not
More informationNational Report on Patient Outcomes in Palliative Care in Australia
National Report on Patient Outcomes in Palliative Care in Australia January June 2013 Report 15 25 th October 2013 PCOC is funded under the National Palliative Care Program and is supported by the Australian
More informationNational Report on Patient Outcomes in Palliative Care in Australia
National Report on Patient Outcomes in Palliative Care in Australia July December 2012 Report 14 May 2013 PCOC is funded under the National Palliative Care Program and is supported by the Australian Government
More informationVictoria: patient outcomes in palliative care: July - December 2013: report 16
University of Wollongong Research Online Australian Health Services Research Institute Faculty of Business 2014 Victoria: patient outcomes in palliative care: July - December 2013: report 16 Alanna M.
More informationPatient Outcomes in Palliative Care for NSW and ACT
Patient Outcomes in Palliative Care for NSW and ACT July to December 215 PCOC is a national palliative care project funded by the Australian Government Department of Health The Palliative Care Outcomes
More informationPatient Outcomes in Palliative Care
The Birds Nest Palliative Care Service (Example of a PCOC Service Report) Patient Outcomes in Palliative Care July December 2012 Report 14 May 2013 PCOC is funded under the National Palliative Care Program
More informationTrends in patient outcomes
Trends in patient outcomes 2009-2016 July 2017 PCOC is a national palliative care project funded by the Australian Government Department of Health About this report This report provides a national summary
More informationPatient outcomes in Palliative Care
Patient outcomes in Palliative Care National report July - December 17 March 18 PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au What
More informationSERVICE SPECIFICATION 6 Conservative Management & End of Life Care
SERVICE SPECIFICATION 6 Conservative Management & End of Life Care Table of Contents Page 1 Key Messages 2 2 Introduction & Background 2 3 Relevant Guidelines & Standards 2 4 Scope of Service 3 5 Interdependencies
More informationRegional Strategic Plan
Regional Strategic Plan 2012-15 Vision Working collaboratively with stakeholders and the community, so that people in the Loddon Mallee Region with a progressive life-limiting illness and their families/carers,
More informationPalliative Care. Anticipatory Prescribing Guidelines & June Gippsland Region Palliative Care Consortium Clinical Practice Group
Palliative Care Anticipatory Prescribing Guidelines June 2016 Gippsland Region Palliative Care Consortium Clinical Practice Group Policy No. Title Keywords Ratified GRPCC-CPG008_1.1_2016 Anticipatory Prescribing
More informationCare of the dying in End Stage Kidney Disease (ESKD) - Conservative. Elizabeth Josland Renal Supportive Care CNC St George Hospital
Care of the dying in End Stage Kidney Disease (ESKD) - Conservative Elizabeth Josland Renal Supportive Care CNC St George Hospital Introduction What does conservative management look like? How does the
More informationObjectives 2/11/2016 HOSPICE 101
HOSPICE 101 Overview Hospice History and Statistics What is Hospice? Who qualifies for services? Levels of Service The Admission Process Why Not to Wait Objectives Understand how to determine hospice eligibility
More informationSupportive and Palliative care for patients with Pancreatic Cancer. Dr Holly Taylor September 2018
Supportive and Palliative care for patients with Pancreatic Cancer Dr Holly Taylor September 2018 Aims of this session To discuss the principles of supportive and palliative care Identification of patients
More informationFOR RESIDENTIAL FACILITIES
AGED CASP 1a - APMHS REFERRAL ACASP 1a AGED PERSONS MENTAL HEALTH SERVICE REFERRAL FOR RESIDENTIAL FACILITIES Surname:. Rapid UR:. Given names:... D.O.B.:. Sex: Address: Phone:.. Medicare Number:. Date
More informationOxygen Use in Palliative Care Guideline and Flowchart
Oxygen Use in Palliative Care Guideline and Flowchart Reviewed: October 2013 Gippsland Region Palliative Care Consortium Clinical Practice Group Policy. Title Keywords Ratified Oxygen Use in Palliative
More informationThe GSF Prognostic Indicator Guidance
4 th Edition September 2011 The GSF Prognostic Indicator Guidance The National GSF Centre s guidance for clinicians to support earlier recognition of patients nearing the end of life Why is it important
More informationPalliative & End of Life Care in Frailty & Dementia. Dr Ruth Ting Palliative Care Consultant Gateshead
Palliative & End of Life Care in Frailty & Dementia Dr Ruth Ting Palliative Care Consultant Gateshead One Chance to get it right How people die remains in the memory of those who live on Dame Cicely Saunders
More informationWATERLOO WELLINGTON INTEGRATED HOSPICE PALLIATIAVE CARE TRANSITIONING PATIENTS REQUIRING HOSPICE PALLIATIVE CARE FROM ACUTE CARE TO COMMUNITY CARE
WATERLOO WELLINGTON INTEGRATED HOSPICE PALLIATIAVE CARE TRANSITIONING PATIENTS REQUIRING HOSPICE PALLIATIVE CARE FROM ACUTE CARE TO COMMUNITY CARE Prepared by Andrea Martin, Waterloo Wellington Integrated
More informationRegional Breathlessness Audit - Case Note Survey. 1. Introduction. Regional Breathlessness Audit - Case Note Survey. 2.
Regional Breathlessness Audit - Case te Survey 1. Introduction Please complete this form for your case note review. Cases used may be PROSPECTIVE AND/OR RETROSPECTIVE. Please log as many cases as you can.
More informationSymptom Assessment Scale (SAS) + Palliative Care Problem Severity Score (PCPSS)
Symptom Assessment Scale (SAS) + Palliative Care Problem Severity Score (PCPSS) Funded under the National Palliative Care Program and is supported by the Australian Government Department of Health and
More informationPalliative Care and Hospice. Silver Linings: Reflecting on Our Past & Transitioning into our Future
Palliative Care and Hospice Silver Linings: Reflecting on Our Past & Transitioning into our Future Objectives: 1. What is Palliative Care? What is Hospice? What is the difference? 2. What are the trending
More informationTable to Demonstrate a method of working through Triggered CAPs.
CAP Problem Goals Triggers Guidelines Physical Activities increase hours of exercises Reports less than 2 hours Personal choice Promotion and physical activity activity in last 3 days Instrumental Activities
More informationAlzheimer s Disease, Dementia, Related Disorders
Alzheimer s Disease, Dementia, Related Disorders Stage 7 on the FAST Scale signifies the threshold of activity limitation that would support a six-month prognosis. The FAST Scale does not address the impact
More information2018 OCN Keywords January 22, 2018 Subject Area Weight Keywords
Subject Area Weight Keywords Care Continuum 19% Care Continuum Coordination of Care Navigation Psychosocial Symptom Management Health Promotion/Screening and Early Detection Disease Prevention High-Risk
More informationMidazolam for Agitation - Baseline
Midazolam for Agitation - Baseline Staff email Participant ID Date of Baseline w D-M-Y H:M Initials of person entering data Demographics Gender Male Female Age Weight (kg) Height (cm) Page 1 Primary life
More informationGippsland Region Palliative Care Consortium (GRPCC) La Trobe University Palliative Care Unit (LTUPCU) Brief report
Gippsland Region Palliative Care Consortium (GRPCC) La Trobe University Palliative Care Unit (LTUPCU) Developing capacity for palliative care in Gippsland: The role of the Gippsland Region Palliative Care
More informationDiagnoses, symptoms and outcomes in aged care residents referred to a community palliative care service
Diagnoses, symptoms and outcomes in aged care residents referred to a community palliative care service Dr. Catherine Brimblecombe Aged Care Registrar, Western Health Advanced Trainee in Geriatric & Palliative
More informationANAMORELIN FOR CACHEXIA. Series 20 CASE REPORT FORM
1 ANAMORELIN FOR CACHEXIA Series 20 CASE REPORT FORM Palliative Care Clinical Studies Collaborative (PaCCSC) RAPID Pharmacovigilance in Palliative Care The case report form (CRF) is to be completed in
More informationSouth East Coast Operational Delivery Network. Critical Care Rehabilitation
South East Coast Operational Delivery Networks Hosted by Medway Foundation Trust South East Coast Operational Delivery Network Background Critical Care Rehabilitation The optimisation of recovery from
More informationCourse Handouts & Disclosure
ALS: DISEASE TRAJECTORY AND HOSPICE ELIGIBILITY Terri L. Maxwell PhD, APRN VP, Strategic Initiatives Weatherbee Resources Inc Hospice Education Network Inc Course Handouts & Disclosure To download presentation
More informationTEMPLATE CASE REPORT FORM. Rapid Response Pharmacovigilance in Palliative Care
TEMPLATE CASE REPORT FORM Rapid Response Pharmacovigilance in Palliative Care The case report form is to be completed in compliance with PaCCSC Standard Operating Procedures 1 Staff email: Participant
More informationAugust 16, Healthy Living Conference For Seniors and Caregivers VITAS 1. What we Know. Defining Palliative Care: Comfort. Symptom Management.
Comfort. Symptom Management. Respect. & Hospice Care Pam Wright, LCSW Licensed Clinical Social Worker pamela.wright@vitas.com 626-918-2273 What we Know Defining : Palliative care is medical care that relieves
More informationDetermining Eligibility for Hospice Care
Determining Eligibility for Hospice Care Main Number: 203 739-8300 Toll Free Number: 888 357-3334 www.regionalhospicect.org Many people may not understand all that Regional Hospice can offer or they are
More informationPlease make sure that you complete a self-assessment survey for each type of rehab program that your organization provides.
Oncology Rehab s Framework Self-Assessment Tool Inpatient Rehab Survey for Oncology Rehab INTRODUCTION: In response to a changing rehab landscape in which rehabilitation is offered in many different settings
More informationSymptoms Assess symptoms and needs across all domains. Screen using Edmonton Symptom Assessment System (ESAS) for: Pain Nausea Depression
A Palliative Care Approach for Oncology Integrating a palliative care approach earlier in the disease trajectory improves the quality of living and dying, and relieves suffering for patients and families
More informationPalliative care competencies: is it for all? Khon Kaen International Conference in Palliative Care 2018
Palliative care competencies: is it for all? Khon Kaen International Conference in Palliative Care 2018 Definition Competence The ability to do something successfully or efficiently For us it means reaching
More informationReport on Feedback from Victorian Palliative Care Services. Capacity to meet demand, resources requirements and priorities.
Report on Feedback from Victorian Palliative Care Services Capacity to meet demand, resources requirements and priorities May 2017 Approved for release by the PCV Board. Palliative Care Victoria wishes
More informationEnd of Life Care in Dementia. Sue Atkins Dignity in Care/Dementia/Learning Disabilities Clinical Nurse Specialist
End of Life Care in Dementia Sue Atkins Dignity in Care/Dementia/Learning Disabilities Clinical Nurse Specialist Objectives Understanding the decline in people with dementia To recognise when patients
More informationPatient outcomes in Palliative Care
Patient outcomes in Palliative Care Victoria January June 18 September 18 PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au What is PCOC?
More informationTemiskaming Hospital Hospice Palliative Care. Presented by: Dr. Don Davies January 31, 2017
Temiskaming Hospital Hospice Palliative Care Presented by: Dr. Don Davies January 31, 2017 Objectives Talk a little about Palliative Care. In general A quick look at Temiskaming District and Hospice Model
More informationMental Health in STH Mike Richmond, Medical Director Mark Cobb, Clinical Director of Professional Services Debate & Note
SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST EXECUTIVE SUMMARY REPORT TO THE TRUST HEALTHCARE GOVERNANCE COMMITTEE E TO BE HELD ON 27 FEBRUARY 2012 Subject: Supporting Director: Author: Status 1 Mental
More informationAiming for Excellence in Stroke Care
Training Centre in Sub-acute Care (TRACS WA) Aiming for Excellence in Stroke Care A tool for quality improvement in stroke care Developed by TRAining Centre in Subacute Care (TRACS WA) February 2016 For
More informationRatified by: Care and Clinical Policies Date: 17 th February 2016
Clinical Guideline Reference Number: 0803 Version 5 Title: Physiotherapy guidelines for the Management of People with Multiple Sclerosis Document Author: Henrieke Dimmendaal / Laura Shenton Date February
More informationInvitation and Family Questionnaire
Invitation and Family Questionnaire RELIEF, COMFORT AND SUPPORT: Palliative Approach Family Meeting Adapted from The University of Queensland The University of Queensland/ Blue Care Research and Practice
More informationIntegrating Renal & Palliative Care Nurse-Led Intervention
Ballarat Hospice Care Inc. & Ballarat Health Service- Dialysis Shared Care Model Integrating Renal & Palliative Care Nurse-Led Intervention SMRPCC Clinical Forum, 20 th May 2016 Vicky Smith, RN MANP Palliative
More informationThe Palliative Care Quality Improvement Project in regional WA
The Palliative Care Quality Improvement Project in regional WA Claire Johnson 1, Tanya Pigeon 1, Valerie Colgan 2, H Walker 2 1 Cancer and Palliative Care Research and Evaluation Unit, The University of
More information2010 National Audit of Dementia (Care in General Hospitals) Chelsea and Westminster Hospital NHS Foundation Trust
Royal College of Psychiatrists 2010 National Audit of Dementia (Care in General Hospitals) Organisational checklist results and commentary for: NHS Foundation Trust The 2010 national audit of dementia
More information2010 National Audit of Dementia (Care in General Hospitals)
Royal College of Psychiatrists 2010 National Audit of Dementia (Care in General Hospitals) Organisational checklist results and commentary for: Barking, Havering and Redbridge Hospitals NHS Trust The 2010
More informationThe role of palliative care in non-malignant disease
The role of palliative care in non-malignant disease Dr. Tony O Brien Consultant Physician in Palliative Medicine Marymount Hospice & Cork University Hospital School of Medicine, University College, Cork
More informationPatient outcomes in Palliative Care
Patient outcomes in Palliative Care Queensland July December 217 March 218 PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au What is PCOC?
More informationPRIMARY CARE CO-COMMISSIONING COMMITTEE 8 SEPTEMBER 2015
Part 1 Part 2 PRIMARY CARE CO-COMMISSIONING COMMITTEE 8 SEPTEMBER 2015 Title of Report Trafford Palliative care Quality Premium Scheme 2015/16 Purpose of the Report The purpose of the report is to detail
More informationPalliative Care Consultative Service in Acute Hospital - Impact & Challenges
Palliative Care Consultative Service in Acute Hospital - Impact & Challenges Dr. Annie Kwok Consultant Palliative Care Unit Department of Medicine & Geriatrics Caritas Medical Centre Contents Aging population
More informationDudley End of Life and Palliative Care Strategy Implementation Plan 2017
Dudley End of Life and Palliative Care Strategy Implementation Plan 2017 End of Life and Palliative Care Strategy 2017 1 Contents Page What is a strategy plan? 3 Terminology 3 Demographics 3 Definitions
More information2010 National Audit of Dementia (Care in General Hospitals) North West London Hospitals NHS Trust
Royal College of Psychiatrists 2010 National Audit of Dementia (Care in General Hospitals) Organisational checklist results and commentary for: rth West London Hospitals NHS Trust The 2010 national audit
More informationStandard Operating Procedure: Early Intervention in Psychosis Access Times
Corporate Standard Operating Procedure: Early Intervention in Psychosis Access Times Document Control Summary Status: New Version: V1.0 Date: Author/Owner: Rob Abell, Senior Performance Development Manager
More informationRehabilitation/Geriatrics ADMISSION CRITERIA. Coordinated Entry System
Rehabilitation/Geriatrics ADMISSION CRITERIA Coordinated Entry System Table of Contents Rehabilitation and Geriatric Service Sites 3 Overview of Coordinated Entry System...4 Geriatric Rehabilitation Service
More informationCare in the Last Days of Life
Care in the Last Days of Life Introduction This guideline is an aid to clinical decision making and good practice in person-centred care for patients who are deteriorating and at risk of dying. The patient
More informationPALLIATIVE MEDICINE Nigel Sykes St Christopher s Hospice London UK
Guttmann Conference June 2013 PALLIATIVE MEDICINE Nigel Sykes St Christopher s Hospice London UK Palliative Medicine What is Palliative Medicine and where did it come from? The extent and organisation
More informationCriteria and Guidance for Referral to Specialist Palliative Care Services
Criteria and Guidance for Referral to Specialist Palliative Care Services March 2014 Introduction This guidance is for health professionals caring for patients who may need referral to specialist palliative
More informationNATIONAL REHABILITATION HOSPITAL (NRH) THE SPINAL CORD SYSTEM OF CARE (SCSC) PROGRAMME INPATIENT SCOPE OF SERVICE
NATIONAL REHABILITATION HOSPITAL (NRH) THE SPINAL CORD SYSTEM OF CARE (SCSC) PROGRAMME INPATIENT SCOPE OF SERVICE NATIONAL REHABILITATION HOSPITAL SCOPE OF SERVICE FOR THE SPINAL CORD SYSTEM OF CARE PROGRAMME
More informationHospice Eligibility August 2018
Hospice Eligibility August 2018 Objectives Identify who can make a hospice referral Review hospice eligibility and disease-specific prognostic indicators Review Open Access philosophy Who Can Make A Referral
More informationRenal Palliative Care Last Days of Life
Renal Palliative Care Last Days of Life Introduction This guideline is an aid to clinical decision-making and good practice for patients with stage 4-5 chronic kidney disease (egfr
More informationNational Palliative Care Strategy 2017 Draft 2.1. Draft AUGUST 2017 DRAFT 2.1 PREPARED FOR DEPARTMENT OF HEALTH
National Palliative Care Strategy 2017 2.1 AUGUST 2017 DRAFT 2.1 PREPARED FOR DEPARTMENT OF HEALTH To receive this document in an accessible format phone 02 8233 9909, using the National Relay Service
More informationHospice Basics and Benefits
Hospice Basics and Benefits Goal To educate health care professionals about hospice basics and the benefits for the patient and family. 2 Objectives Describe the history and philosophy of the hospice movement
More informationPURPOSE OF THE SELF-ASSESSMENT TOOLS:
Pulmonary Rehab s Framework Self-Assessment Tool Inpatient Rehab Survey for Pulmonary Rehab INTRODUCTION: In response to a changing rehab landscape in which rehabilitation is offered in many different
More informationPatient Outcomes in Palliative Care
South Australia Patient Outcomes in Palliative Care January June 2015 September 2015 PCOC is a national palliative care project funded by the Australian Government Department of Health www.pcoc.org.au
More information2010 National Audit of Dementia (Care in General Hospitals) Guy's and St Thomas' NHS Foundation Trust
Royal College of Psychiatrists 2010 National Audit of Dementia (Care in General Hospitals) Organisational checklist results and commentary for: Guy's and St Thomas' NHS Foundation Trust The 2010 national
More informationThere For You. Your Compassionate Guide. World-Class Hospice Care Since 1979
There For You Your Compassionate Guide World-Class Hospice Care Since 1979 What Is Hospice? Hospice is a type of care designed to provide support during an advanced illness. Hospice care focuses on comfort
More informationSTOP, LOOK AND LISTEN: Supporting people with dementia and their families at the end of life
STOP, LOOK AND LISTEN: Supporting people with dementia and their families at the end of life #DementiaEoLC Today 10.00 - Chair s welcome: Anita Hayes 10.10 - Setting the scene: Anita Hayes and Dr Jackie
More informationPalliative Care in the ED:
Palliative Care in the ED: Don t Just Do Something Stand There Eric Isaacs, MD, FACEP Attending Physician, San Francisco General Hospital and Trauma Center Professor of Emergency Medicine, University of
More informationRoad Blocks in Non-Cancer Palliative Care Obstacles observed from outpatient non-cancer palliative practice.
Road Blocks in Non-Cancer Palliative Care Obstacles observed from outpatient non-cancer palliative practice. 25th Annual Palliative Education and Research Days, West Edmonton Mall. Edmonton. 2014 Amanda
More informationPalliative Care Emergencies
Palliative Care Emergencies LAURA BARNFIELD What might constitute an emergency in Palliative Care? 1 Palliative Care Emergencies Major haemorrhage Metastatic Spinal Cord Compression (MSCC) Superior Vena
More informationLife is pleasant. Death is peaceful. It s the transition that s troublesome. Isaac Asimov ( )
Life is pleasant. Death is peaceful. It s the transition that s troublesome. Isaac Asimov (1920-1992) Objectives Palliative care versus hospice care. Admission guidelines to hospice services. Having the
More informationPlease FAX completed form to : Admission request: Immediate ADMISSION REFERRAL TO HOSPICE RENFREW
Please FAX completed form to : 613-432-3618 Admission request: Immediate ADMISSION REFERRAL TO HOSPICE RENFREW Future Pain and symptom management Referral Principles -Completion of this referral is a request
More information5 key areas for research, and how to go forward. Primary Palliative Care Research Forum, University of Capetown, September, 2010
5 key areas for research, and how to go forward Primary Palliative Care Research Forum, University of Capetown, September, 2010 Scott A Murray St Columba s Hospice Chair of Primary Palliative Care Primary
More informationGeriatrics and Cancer Care
Geriatrics and Cancer Care Roger Wong, BMSc, MD, FRCPC, FACP Postgraduate Dean of Medical Education Clinical Professor, Division of Geriatric Medicine UBC Faculty of Medicine Disclosure No competing interests
More informationUnderstanding patient pathways and the impact of UTIs on emergency admissions in MS. Sue Thomas CEO
Understanding patient pathways and the impact of UTIs on emergency admissions in MS Sue Thomas CEO Aim Highlight from national and local statistics the impact MS has on the NHS Explain how integrated pathways
More informationApproved Care Model for Project 3gi: Integration of Palliative Care into the PCMH Model
1 Approved Care Model for Project 3gi: Integration of Palliative Care into the PCMH Model OneCity Health Webinar January 13, 2016 Overview of presentation 2 Approach to care model development Project overview
More informationMeasure #403: Adult Kidney Disease: Referral to Hospice National Quality Strategy Domain: Patient and Caregiver-Centered Experience and Outcomes
Measure #403: Adult Kidney Disease: Referral to Hospice National Quality Strategy Domain: Patient and Caregiver-Centered Experience and Outcomes 2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE
More information