The Canadian Society of Palliative Cares Physician has developed a new staffing model for specialist palliative care teams that can deliver an optimal, integrated palliative care program. The model, base on three key interdependent roles palliative care physician, palliative care resource nurse, and social workers is describe in detail in a Special Article publish in Journal of Palliative Medicine, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.
Calculating staffing needs for specialist palliative care services is complex; also there is little publish evidence to suggest best practice. Most of the existing data indicate how many physicians are need per population but does not take into consideration the interdependence of other team members. Staffing needs are often dependent on factors such as patient demographics, access to primary care, competency levels, models of care, and geography, to name a few.
Primary care physicians
The broader inter professional team, in which primary care physicians, nurses; also social workers play a central role, will also include therapists, pharmacists, home healthcare workers, and others. All members of the team are interdependent and need to work collaboratively for this approach to be successful. The article presents a detail description of the model; so the assumptions underlying the model, staffing requirements, and the clinical and non-clinical responsibilities of the team.
The primary care team would identify patients who would benefit; so from a palliative approach early on to facilitate appropriate discussions and care. Recognizing the need for a palliative approach is base on need or potential need and not on time or prognosis. The primary care team continues to assess, educate, manage, and support these patients and families, and ideally creates a roster/monitoring system. Then as changes occur or issues arise; so the degree of care can be adjusted to meet the patient’s goals and needs.
Specialist palliative cares
Palliative care RNs can advise, coach, and model comprehensive palliative care assessments; ensuring that advance care planning, goals of care; also end-of-life care planning takes place in a timely way. They can also help coordinate appropriate and timely care in the various places; so where patients and families want their care to occur (home, care residences, hospice).
Involving the specialist palliative care team, as need, enables the primary care team to remain; so the primary point of contact for the patient. Charles F. von Gunten, MD, PhD, Editor-in-Chief of Journal of Palliative Medicine and Vice President, Medical Affairs, Hospice and Palliative Medicine for the OhioHealth system, states: Palliative care is a team sport. It’s important to develop standards so palliative care isn’t watered down and the impact diminished.”