Cargando…
Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic
BACKGROUND: During the COVID-19 pandemic, hospitals worldwide have reported large volumes of patients with refractory symptoms and a large number of deaths attributable to COVID-19. This has led to an increase in the demand for palliative care beyond what can be provided by most existing programs. W...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135235/ https://www.ncbi.nlm.nih.gov/pubmed/33823653 http://dx.doi.org/10.1177/10499091211005701 |
_version_ | 1783695328162086912 |
---|---|
author | Kaya, Ebru Lewin, Warren Frost, David Hannon, Breffni Zimmermann, Camilla |
author_facet | Kaya, Ebru Lewin, Warren Frost, David Hannon, Breffni Zimmermann, Camilla |
author_sort | Kaya, Ebru |
collection | PubMed |
description | BACKGROUND: During the COVID-19 pandemic, hospitals worldwide have reported large volumes of patients with refractory symptoms and a large number of deaths attributable to COVID-19. This has led to an increase in the demand for palliative care beyond what can be provided by most existing programs. We developed a scalable model to enable continued provision of high-quality palliative care during a pandemic for hospitals without a palliative care unit or existing dedicated palliative care beds. METHODS: A COVID-19 consultation service working group (CWG) was convened with stakeholders from palliative care, emergency medicine, critical care, and general internal medicine. The CWG connected with local palliative care teams to ensure a coordinated response, and developed a model to ensure high-quality palliative care provision. RESULTS: Our 3-step scalable model included: (1) consultant model enhanced by virtual care; (2) embedded model; and (3) cohorted end-of-life unit for COVID-19 positive patients. This approach was enabled through tools and resources to ensure specialist palliative care capacity and rapid upskilling of all clinicians to deliver basic palliative care. Enabling tools and resources included a triage tool for in-person versus virtual care, new medication order sets and guidelines to facilitate prescribing for common symptoms, and lead advance care planning and goals of care discussions. A redeployment plan of generalist physicians and psychiatrists was created to ensure seamless provision of serious illness care. CONCLUSION: This 3-step, scalable approach enables rapid upscaling of palliative care in collaboration with generalist physicians, and may be adapted for future pandemics or natural disasters. |
format | Online Article Text |
id | pubmed-8135235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-81352352021-06-07 Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic Kaya, Ebru Lewin, Warren Frost, David Hannon, Breffni Zimmermann, Camilla Am J Hosp Palliat Care Covid-19 BACKGROUND: During the COVID-19 pandemic, hospitals worldwide have reported large volumes of patients with refractory symptoms and a large number of deaths attributable to COVID-19. This has led to an increase in the demand for palliative care beyond what can be provided by most existing programs. We developed a scalable model to enable continued provision of high-quality palliative care during a pandemic for hospitals without a palliative care unit or existing dedicated palliative care beds. METHODS: A COVID-19 consultation service working group (CWG) was convened with stakeholders from palliative care, emergency medicine, critical care, and general internal medicine. The CWG connected with local palliative care teams to ensure a coordinated response, and developed a model to ensure high-quality palliative care provision. RESULTS: Our 3-step scalable model included: (1) consultant model enhanced by virtual care; (2) embedded model; and (3) cohorted end-of-life unit for COVID-19 positive patients. This approach was enabled through tools and resources to ensure specialist palliative care capacity and rapid upskilling of all clinicians to deliver basic palliative care. Enabling tools and resources included a triage tool for in-person versus virtual care, new medication order sets and guidelines to facilitate prescribing for common symptoms, and lead advance care planning and goals of care discussions. A redeployment plan of generalist physicians and psychiatrists was created to ensure seamless provision of serious illness care. CONCLUSION: This 3-step, scalable approach enables rapid upscaling of palliative care in collaboration with generalist physicians, and may be adapted for future pandemics or natural disasters. SAGE Publications 2021-04-07 2021-07 /pmc/articles/PMC8135235/ /pubmed/33823653 http://dx.doi.org/10.1177/10499091211005701 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Covid-19 Kaya, Ebru Lewin, Warren Frost, David Hannon, Breffni Zimmermann, Camilla Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic |
title | Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic |
title_full | Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic |
title_fullStr | Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic |
title_full_unstemmed | Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic |
title_short | Scalable Model for Delivery of Inpatient Palliative Care During a Pandemic |
title_sort | scalable model for delivery of inpatient palliative care during a pandemic |
topic | Covid-19 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135235/ https://www.ncbi.nlm.nih.gov/pubmed/33823653 http://dx.doi.org/10.1177/10499091211005701 |
work_keys_str_mv | AT kayaebru scalablemodelfordeliveryofinpatientpalliativecareduringapandemic AT lewinwarren scalablemodelfordeliveryofinpatientpalliativecareduringapandemic AT frostdavid scalablemodelfordeliveryofinpatientpalliativecareduringapandemic AT hannonbreffni scalablemodelfordeliveryofinpatientpalliativecareduringapandemic AT zimmermanncamilla scalablemodelfordeliveryofinpatientpalliativecareduringapandemic |