Introduction to Ambulatory Palliative Care

MedEdPORTAL

Bethany-Rose Daubman¹  Eva Chittenden² 

[1] 1 Massachusetts General Hospital;2 Massachusetts General Hospital;

关键词: Palliative Care;    Goals of Care;    Patient Care Planning;    Outpatients;    Ambulatory Medicine;    Symptom Management;   

DOI  :  10.15766/mep_2374-8265.10338

来源: DOAJ

【 摘 要 】

Abstract Introduction This resource is a combination of slide-based didactic materials, interactive workshop, and case-based learning aimed at discussing the role of palliative care in the ambulatory setting. Palliative care is often thought of as end-of-life care, taking place either at home (traditionally via hospice) or via the inpatient consultation model. Existing palliative care curricula often focus on these two domains and attempt to refashion palliative care as it is meant to be: care focused on quality of life at any time along the continuum of a life-limiting illness. At our institution, we also have a mature palliative care clinic embedded in our cancer center. As palliative care practitioners who have worked in all of these settings, we feel we have unique expertise to share with learners. At our institution and in the medical system at large, the role of outpatient palliative care is expanding. Methods This workshop introduces the topic of outpatient palliative care and explores the difference between primary and secondary palliative care. The important findings of improved symptom control and quality of life, as well as the unexpected finding of prolonged survival, are discussed, as are the intervention and explore explanations for these findings. The second part of the workshop involves a patient case of advanced lung cancer. The case serves as an exemplar of specialty-level palliative care embedded in a tertiary care cancer center. The case, which is presented interactively, demonstrates symptom management, with an epilogue about advance care planning discussions. Results Four teaching sessions were conducted in the 2014–2015 academic year with anonymous feedback (both quantitative and qualitative) obtained after each. A total of 37 learners provided feedback. Quantitative feedback was obtained on a 5-point Likert scale (strongly agree to strongly disagree). When asked if the session was clinically useful, 51% strongly agreed, and 49% agreed. When asked if the teacher and teaching methods were effective, 65% strongly agreed, and 35% agreed. When asked if the session would change or improve their clinical practice, 38% strongly agreed, 59% agreed, and 3% were unsure. Discussion At our institution and in the medical system at large, the role of outpatient palliative care is expanding. This resource is a combination of slide-based didactic materials, interactive workshop, and case-based learning aimed at discussing the role of palliative care in the ambulatory setting.

【 授权许可】

Unknown