Improving And Maintaining Standards Of Palliative Care
Palliative care, as defined by Fatmata and as obtainable in practice has indisputably been an advantageous strategy to reducing the pain and distress of patients and their loved ones. However, her view about the Liverpool Care Pathway (LCP) is somewhat untrue as the LCP model was actually introduced after a number of researches in the United Kingdom Medical Community showed that the standard of care during end of life were patchy. Although, her opinion on progress of palliative care remains valid as subsequent researches and contributions by scholars have led to the improvement and strengthening of the care system.
I agree with the take of Fatmata that hospices in the UK have indeed achieved laudable feats in the delivery of palliative care, especially through the use of multidisciplinary teams which provide specialist healthcare. There truly is however the need to develop new models or upgrade old ones in order to match up with current demands, especially, of patients and their family members and also to address existing challenges that are yet to be effectively handled. Also handy is the suggestion of Fatmata that hospices should engage in effective information dissTackling the issue of inequality among disadvantaged groups is a thing worth the attention of healthcare organisations as suggested by Fatmata. Her suggestion to adopt personalised care, I agree is a promising step that will not only foster increased inclusion but will also redefine patient satisfaction as patients or their loved ones will possess greater control of their personal care, seemingly having it when they need it and how they want it. This is the shift in healthcare delivery even though the ideology is not entirely new. It will aid more patient-centered and lasting care for individuals who have long-term or terminal health conditions.
I agree with the indication of Fatmata which pointed out the fact that patients' health has higher likelihood to worsen within out-of-hours period, hence, the validity of the recommendation by the National Institute of Health and Care Excellence to have a seven day a week service delivery. The compliance difficulty however has made the telephone advice mode a viable option as patients can have contact with a professional out of working hours and if necessary, have a face to face visiting over weekends, holidays or when having any major health crisis outside the regular working hours.
The improvement of the standard of palliative care is relative to the needs and preferences of the care receiver as well as the family of the individual. Although, some people wish or would prefer to die at home, most individuals in the European region die in a hospital. According to Allingham et. al., (2013), 17 percent of individuals who are older than the age of 65 years die in care homes and considering the aging population, there is a likelihood that the figures will rise. In light of this, the improvement and maintenance of standards in the delivery of palliative care must of necessity cover the improvement of care at home, in hospices as well as other health care systems.
A hospital based multidisciplinary palliative care team is one solid means of strengthening the quality and standards of palliative care. With the composition of specialists from various fields enabling team work, the needs of patients will be effectively and satisfactorily served.
Also, the development of standard guidelines for palliative care home was suggested to maintain a quality standard. Other means by which standards can be maintained or improved is that specialists and family physicians be in charge of home support palliative care delivery to boost the attention and quality of service given to patients.
The use of recent models to meet modern needs in hospices
Palliative care as a specialty has been through several stages of growth over the years. Also, the level of satisfaction and preferences of patients and family members of care receivers are dynamic, hence, the need for constant review, upgrade and/or change of approach or models in the delivery of palliative care.
As suggested by Temel et. al., (2010), it is imperative that hospices carry out quality assessment on a routine basis so as to ensure that the patient is at the centre of care delivery, this being a key factor in palliative care. Due to general changes in healthcare practices, financing as well as evaluation, the need to develop new models to match up with the current challenges has become inevitable.
Previous models are run majorly based on a reimbursement system which is largely a fee for service system. However, recent models have a common line or theme which is more accountable and based on value delivery and Accountable Care Organisations. This places a responsibility on specialists and medical groups to ensure the quality of palliative care provided as well as hold them accountable for the outcome of the services provided.
Generally, a continuous monitoring of quality as well as clinically derived and tested definitions of quality should be upheld for effective and up to date palliative care delivery.
References
- Dixon J, King D, Matosevic T, Clark M, Knapp M. (2015) Equity in the provision of palliative care in the UK: Review of evidence. Personal Social Services Research Unit, London School of Economics and Political Science
- Royal College of Physicians (2012). An evaluation of consultant input into acute medical admissions management in England. Report of: Hospital service patterns versus clinical outcomes in England
- Temel J. S, Greer J. A, Muzikansky A. (2010) Early palliative care for patients with meta-static non-small-cell lung cancer. N Engl J Med. 2010;363:733
