Related Experiment Videos
Integrated, collaborative palliative care in heart failure: the St. George Heart Failure Service experience 1999-2002
Patricia M Davidson1, Glenn Paull, Kate Introna
1School of Nursing, Family and Community Health, University of Western Sydney, & Western Sydney Area Health Service, Sydney, Australia. patricia_davidson@wsahs.nsw.gov.au
Insights
Integrating palliative care into heart failure (HF) management significantly reduced the need for specialized interventions. This approach improved symptom control and support for HF patients and their families.
Area of Science:
- Cardiology
- Palliative Care
- Geriatric Medicine
Background:
- Chronic heart failure (HF) is a growing concern, particularly in aging populations, with poorer outcomes than many cancers.
- Patients with HF often miss out on palliative care's benefits, including symptom management and emotional support.
Purpose of the Study:
- To develop an integrated, consultative palliative care model within a community-focused heart failure disease management program.
Main Methods:
- A collaborative model was created using needs assessment and resource documentation.
- Key principles included communication, consultancy, and skill development.
- A universal healthcare system supported patient and family co-management.
Main Results:
- Only 8.3% of HF patients required specialized palliative care for complex symptoms, support, or spiritual issues.
- Twenty percent of patients died in nursing homes, highlighting the need for nursing support.
Conclusions:
- Palliative care strategies can be integrated into HF management programs.
- Support and consultancy from expert palliative care services are crucial for success.
Background:
Chronic heart failure (HF) is the only heart condition increasing in prevalence and is primarily a condition of aging. This condition has outcomes worse than many cancers; however, patients are often denied the benefits of palliative care with its important emphasis on symptom management, spirituality, and emotional health and focus on family issues.
Aim:
To describe the development of a model of an integrated, consultative, palliative care approach within a comprehensive HF community-focussed disease management program.
Method:
A collaborative model was developed following a systematic needs assessment and documentation of local resources. Principles underpinning this model were based upon fostering of communication, consultancy, and skill development. Within this model a health care system, based upon universal coverage, supported co-management of patients and their families. The place of death, level of social support available at home, and degree of palliative care involvement was documented in 121 consecutive deaths from 1999-2002.
Findings:
Following a period of skill sharing and program development, only 8.3% of HF patients in the collaborative program required specialized palliative care intervention for complex symptom management, carer support, and issues related to spirituality. Twenty percent of this cohort died in nursing homes underscoring the importance of supporting our nursing colleagues in this setting.
Conclusions:
In spite of well-documented difficulties in determining prognosis, it is the St George experience that key principles of a palliative care strategy can be implemented in a HF disease management program with support and consultancy from expert palliative care services.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
01:27Coronary Artery Disease V: Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care
01:29Cardiomyopathy V: Interprofessional Care
01:30Heart Failure VII: Nursing Interventions
01:25Continuing Care