Improving clinic utilization and workload capture for clinical pharmacy specialists.
CONCLUSION: The increases in clinic utilization, total encounters, and interventions observed for the clinical pharmacy specialists suggest the beneficial role of pharmacy administrators' collaboration with clinical pharmacy specialists to improve workload capture and access to quality care, to justify clinical pharmacy services, and to identify opportunities for pharmacy clinical intervention. PMID: 32061094 [PubMed - as supplied by publisher]
Ageing adults (65+) with disability are especially vulnerable to COVID-19 and upon contracting, are a cohort most likely to require palliative care. Therefore, it is very important that health services - particularly health services providing palliative care - are proximately available. Treating the Melbourne metropolitan area as a case-study, a spatial analysis was conducted to clarify priority areas with a significantly high percentage and number of ageing adults (65+) with disability, and high barriers to accessing primary health services.
The COVID-19 pandemic created a rapid and unprecedented shift in our medical system. Medical providers, teams, and organizations have needed to shift their visits away from face-to-face visits and toward telehealth (both by phone and through video). Palliative care teams who practice in the community setting are faced with a difficult task: How do we actively triage the most urgent visits while keeping our vulnerable patients safe from the pandemic?
Doctors caring for patients with life-limiting illness are often exposed to emotional distress.
The disparity between gaps in workforce and availability of palliative care (PC) services is an increasing issue in health care. To meet the demand, team-based PC requires additional educational training for all clinicians caring for persons with serious illness.
Covid-19 is rapidly spreading across the world. Many patients will present with a high symptom burden, which specialists in palliative care can help manage. Whilst the focus in the media has been on mechanical ventilation, increasing numbers of patients will not be suitable for this support due to underlying health conditions. Instead, they will require a conservative approach and palliative care management.
Symptom management and skilled communication with patients and families are essential clinical services in the midst of the COVID-19 pandemic. While palliative care specialists have training in these skills, many front-line clinicians from other specialties do not. It is imperative that all clinicians responding to the COVID-19 crisis have access to clinical tools to support symptom management and difficult patient and family communication.
When our palliative care unit was closed to make room for COVID-19 patients, we were prepared. The virus had made its way to our shores in Singapore by January 23, 2020 (1). At the initial stages, Singapore, being the hyper-connected city that it is, was the country with the most confirmed COVID-19 cases outside of China (2). We are part of a large general hospital of 1800 beds with a 13-Bed Acute Palliative Care Unit and a busy inpatient referral and outpatient service. We are also situated next to the National Centre of Infectious Diseases where the majority of COVID-19 positive or suspected patients were housed.
In the article, Personalized Goal for Dyspnea and Clinical Response in Advanced Cancer Patients (J Pain Symptom Manage. 2019 Jan;57(1):79-85. doi: 10.1016/j.jpainsymman.2018.10.492. Epub 2018 Oct 16.), Dr Romina Rossi's affiliation was incorrectly labeled. Dr Rossi’s affiliation should be Palliative Care Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì -Cesena, Italy.
Specialist Palliative Care services (SPCS) have a vital role to play in the global COVID-19 pandemic. Core expertise in complex symptom management, decision-making in uncertainty, advocacy and education, and ensuring a compassionate response are essential, and SPCS are well positioned to take a proactive approach in crisis management planning.SPCS resource capacity is likely to be overwhelmed, and consideration needs to be given to empowering and supporting high-quality primary palliative care in all care locations.
CONCLUSION: The absence of opioid stewardship and prospectively screening ORAEs represents a gap in current practice at surveyed hospitals. Hospitals have an opportunity to implement and refine best practices such as access to pain management specialists, use of formulary restrictions, and retrospective and prospective monitoring of adverse events to improve opioid use. PMID: 32236455 [PubMed - in process]