This episode features Dr Catriona Mayland (University of Sheffield, UK).
The Quality of Death Index showed variability in the international provision of care for the dying. In order to improve care, we need to have validated outcome measures to assess the current quality of care. One method of evaluation is to use the views from the bereaved relatives to assess their own perceptions and as proxy measures for the patient. We have developed a common, core international ‘Care Of the Dying Evaluation’ (i-CODE) questionnaire, assessing both patient care and family-carer support. Engagement of patient and public representatives and bereaved relatives has informed the development process adding to the face and content validity of i-CODE. i-CODE will enable a transnational comparison of care for the dying to be conducted. Results of i-CODE can be used directly for quality improvement purposes. i-CODE may be further developed into an international standard and benchmarking tool.
Full paper available from: https://journals.sagepub.com/doi/full/10.1177/0269216318818299
If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: anwosu@liverpool.ac.uk
This episode features Dr Ann Dadich (Western Sydney University, Austrailia)
Specialist home-based palliative care can improve symptom management and quality of life and prevent hospitalisation at the end-of-life. There is significant variation in how home-based palliative care is delivered, even within similar jurisdictions. The clinical practices and contextual factors that enable exemplary palliative care are not well understood. The study identified some of the characteristics that enable brilliant home-based palliative care – notably: anticipatory aptitude and action; a weave of commitment among different individuals, within and beyond a palliative care service; flexible adaptability; and team capacity-building. Using the combined methodology of positive organisational scholarship in healthcare and video-reflexive ethnography, this study also revealed the importance of context in delivering brilliant home-based palliative care. The aforesaid conditions can be adapted for use within other services, particularly those committed to brilliant palliative care. Despite the contributions of this study, policies are required to guide and sustain brilliant home-based palliative care across different settings.
Full paper available from: https://journals.sagepub.com/doi/full/10.1177/0269216318807835
If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: anwosu@liverpool.ac.uk
This episode features Dr Simon Etkind (Cicely Saunders Institute, King’s College London, London, UK).
To be person-centred, care should take into account individual preferences. Some influences on care preferences in older people have been described. These include the family and care context, individual response and illness-related factors. Older people living with frailty are at high risk of acute illness episodes; the influences on preferences in the context of frailty and recent acute illness have not been explored. Achieving normality, by ‘getting back to normal’ or ‘finding a new normal’ influences preferences in frail older people with recent acute illness, as participants seek care that will help them find this normality. Preferences are also influenced by the way people respond to changing health and care experiences. We propose a model of influences on care preferences in the context of recent acute illness. The influences described in this model can act as a guide for discussion and elicitation of current and future care preferences in this population. When addressing care preferences with patients and families, clinicians should discuss what may be an achievable normal for them within their social context. Prospective longitudinal study will allow exploration of influences on the stability of care preferences following acute illness.
Full paper available from: https://journals.sagepub.com/doi/full/10.1177/0269216318817706
This episode features Dr Huw Williams ( Cardiff University, UK)
Around 2% –3 % of consultations in primary care are prone to patient safety incidents. Patients receiving palliative care are not immune to patient safety concerns. ‘Out-of-hours’ services are responsible for providing care for two-thirds of the working week (18:30 to 08:00 on weekdays, and all hours at weekends in the United Kingdom). Target patient safety issues for improving palliative care in the out-of-hours setting include medication provision, timely access to care and non-medication treatments such as catheter care and information transfer between providers. Harm outcomes commonly include pain, emotional distress, unnecessary hospital admission, and hastened death. Interventions to address frequently identified sources of harm are presented and should be evaluated robustly in future implementation studies.
Full paper available from: https://journals.sagepub.com/doi/full/10.1177/0269216318817692
If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: anwosu@liverpool.ac.uk