Publication
Indicators for clinical activity in palliative care: The experience of a regional resources team of paediatric palliative care
Bouffay C, Rollin A, Marcault A, Remy C, Castaing M, Filion S, Petillard E, Fournie F, Schell M · Medecine Palliative · 2017
Context. - The regional resource teams of pediatric palliative care, like any adult mobile palliative care team in France, have to realize an annual report including several indicators that are often imposed by the regional public health authorities. Our regional resource team of pediatric palliative care raised the question of the relevance and performance of the "active list'' (number of patients) as indicator of the clinical activity. Methodology. - All the situations met by our regional resource team of pediatric palliative between 2011 and 2012 were analyzed and then classified. Results. - Four levels of intervention were identified: The first level consists in answering the questions from the professionals: e.g. symptom management, ethical questions and issues, etc. At this level, the regional resource team of pediatric palliative does not meet the child nor his/her family. It often acts by specific interventions, such as telephone calls or meetings between teams. The second level corresponds to the intervention in collaboration with the specialized reference team. The regional resource team of pediatric palliative then meets the child and his family. The regional resource team of pediatric palliative provides support for professionals and the family on the questions of anticipation, clinical worsening, and/or ethical issues when realizing or omitting therapeutic acts. The hospital team remains the reference team. The third level involves the regional resource team of pediatric palliative in collaboration with the reference team but becomes progressively itself the reference team for the child, his family and other caregivers. This may occur in home-care based situations. This level includes that regional resource team of pediatric palliative often coordinates the home-care providers (nurses, general practitioner, etc.) and that its main activity is to support the families and the child. At this level, the regional resource team of pediatric palliative is called if needed as the first line team. Finally, the fourth level can be summed up as all situations for which the regional resource team of pediatric palliative is the only involved team, e.g. bereavement support. Conclusion. - The approach and the identification of the four levels describe more specifically the clinical activity of the regional resource teams of pediatric palliative in their various assumptions of responsibilities. Further on, it identifies more precisely the implication of all teams involved. Thinking in levels of implication is innovative and adjusted with clinical reality. The levels of intervention may change during the care pathway of each child. This tool for evaluation of the clinical activity finds an interest within our network of all regional resource teams of pediatric palliative. Perhaps its use could also be relevant for other palliative care networks or mobile teams. (C) 2017 Elsevier Masson SAS. All rights reserved.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.