palliative care services in settings & demographic scenarios
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. OSI/WHOCC Workshop 4. Palliative Care Services in Settings & demographic scenarios. Xavier Gómez-Batiste MD, PhD Director, WHO Collaborating Center for Public Health Palliative Care Programs. Implementing Palliative Care Specialist Services. - PowerPoint PPT PresentationTRANSCRIPT
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
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Palliative Care Services in Settings & demographic scenarios
Xavier Gómez-Batiste MD, PhDDirector, WHO Collaborating Center for Public Health Palliative Care Programs
OSI/WHOCC Workshop 4
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Implementing Palliative Care
Specialist Services
Institut Català d’Oncologia
Specific Resources / settings
Units
Support teams
Outp’s / Day care
Acute Hospitals
Nursing homes
Mid term and long term, RHB, (Sociohealth Centers)
Hospices
Community / home
Institut Català d’Oncologia
Types of services and Levels of complexity
General measures in conventional Services (Hospitals, Primary care, Nursing homes, Emergencies, etc)
Basic suport teams (home, hospitals, comprehensive)
Reference:
complexity+ training+ research
Complete teams Units
Transitional measures: individual Specialist nurses or consultants
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Standards of specific resources
• 1 support team at home / 100.000 h• 80-100 beds / milion habitants (10-20% acute, 40-60% mid term, 20-30% nursing
homes)
• 20-25 full time doctors / milion habitants
• 1 team available in every hospital (units in teaching)
• Models of organisation adapted to demographic scenarios: metropolitans, intermediate, or small sectors < 100.000
• Models in specific resources (cancer institutes, nursing homes, etc)
XGB 2005, WHOCC, 2008
Institut Català d’Oncologia
Implementation strategies of services:
initial phases• To create a nucleus of solid
experiences• Combine different types: home,
hospital, cancer, geriatric,….• Based in feasibility: active leaders,
institutional comittment, …. • Cathalitic measures: support teams,
transitional, …• Define services before starting
implementation
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Models of organisation in
demographic and geographic scenarios
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Sectorized Planning
Needs:Demography
urban, rural, mixed
Resources
Type
cancer, geriatrics, AIDS, other
Complexity
low/high
Mortality / Prevalence
low/high
Specialist Services
+ General
Measures in conventional services
Direct coverage for complex diseases
Good care for non-complex diseases
• Criteria intervention
• Continuing / emergency care
• Coordination
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Demographic and setting scenarios• Demographic• Rural• Urban• Rural-urban• Metropolitan
• Settings• Primary/community care• Nursing homes• Longterm / intermediate• Hospitals: district
general, university• Cancer Institutes
Adapt the organisation to needs and contexts
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Exercise
• Select one setting in your country
• Discuss the models of organization of palliative care services in that setting
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
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The ‘Qualy’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes
[email protected]+34 93 260 77 36
ICO l’HospitaletHospital Duran i ReynalsGran Via de l’Hospitalet, 199-20308908 l’Hospitalet de Llobregat
Institut Català d’Oncologia