Palliative care in Dutch hospitals: a rapid increase in the number of expert teams, a limited number of referrals
Palliative care in Dutch hospitals: a rapid increase in the number of expert teams, a limited number of referrals
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DOI：
10.1186/s12913-016-1770-2
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发表时间：
2016-09-23
影响因子：
2.8
通讯作者：
van der Heide, A.
中科院分区：
文献类型：
--
作者：
Brinkman-Stoppelenburg, A.;Boddaert, M.;van der Heide, A.
背景资料：医院的姑息治疗专家团队对晚期疾病患者的生活质量和护理满意度有积极的影响。这些医疗队参与医疗保健也可节省大量费用。在荷兰，专业标准规定，到2017年，每家医院都应有一个姑息治疗小组。我们研究了医院的数量，有一个姑息治疗团队和这些teams.Methods的特点：在2015年4月，问卷邮寄给关键姑息治疗专业人员在所有的一般，教学和学术医院在荷兰。在92家医院中，74家（80%）做出了回应。结果：77%的所有参与医院都有姑息治疗团队。其他服务，如门诊诊所（22%）、姑息治疗住院单位（7%）和姑息日间护理设施（4%）相对缺乏。在团队中代表的学科的平均数量是6.5。最常见的学科是护士（72%）和执业护士（54%），内科医生（90%）或麻醉学（75%）和精神护理人员（65%）。在大多数情况下，医生没有标记的时间可用于他们的工作作为姑息治疗顾问，而护士和护士执业。大多数团队（77%）只在办公时间可用。26%的团队不仅可以由医疗保健专业人员咨询，还可以由患者或亲属咨询。每年住院病人的年度咨询次数从2次到680次不等（中位数：77次）。平均而言，团队咨询了0.6%的所有患者入院hospital.Conclusion：荷兰医院的姑息治疗团队的数量正在迅速增加。各小组之间在小组所代表的学科、程序和协商次数方面存在很大差异。制定质量标准和为小组配备充足的工作人员可以提高小组的质量和效力。
Background: Palliative care expert teams in hospitals have positive effects on the quality of life and satisfaction with care of patients with advanced disease. Involvement of these teams in medical care is also associated with substantial cost savings. In the Netherlands, professional standards state that each hospital should have a palliative care team by 2017. We studied the number of hospitals that have a palliative care team and the characteristics of these teams.Methods: In April 2015, questionnaires were mailed to key palliative care professionals in all general, teaching and academic hospitals in the Netherlands. Out of 92 hospitals, 74 responded (80 %).Results: Seventy-seven percent of all participating hospitals had a palliative care team. Other services, such as outpatient clinics (22 %), palliative care inpatient units (7 %), and palliative day care facilities (4 %) were relatively scarce. The mean number of disciplines that were represented in the teams was 6,5. The most common disciplines were nurses (72 %) and nurse practitioners (54 %), physicians specialized in internal medicine (90 %) or anaesthesiology (75 %), and spiritual caregivers (65 %). In most cases, the physicians did not have labeled hours available for their work as palliative care consultant, whereas nurses and nurse practitioners did. Most teams (77 %) were only available during office hours. Twenty-six percent of the teams could not only be consulted by healthcare professionals but also by patients or relatives. The annual number of consultations for inpatients per year ranged from 2 to 680 (median: 77). On average, teams were consulted for 0.6 % of all patients admitted to the hospitals.Conclusion: The number of Dutch hospitals with a palliative care team is rapidly increasing. There are substantial differences between teams regarding the disciplines represented in the teams, the procedures and the number of consultations. The development of quality standards and adequate staffing of the teams could improve the quality and effectiveness of the teams.