|
Collaborative Practice: A Vital Force in Palliative Care
Within palliative care, there are many dimensions of care surrounding the patient and family. These include physical, intellectual, emotional, social, and spiritual aspects of care. No one health care provider can attend to all these dimensions and thus a collaborative approach is the cornerstone of a palliative care team. But what does collaboration truly mean and how is it best implemented?
Collaboration means to work together or similarly to cooperate together. More simply put, the team must work together towards a common goal. The goal is a plan of care based on the patient’s values, preferences, beliefs and culture. The National Consensus Project Clinical Guidelines for Quality Palliative Care outlines basic assumptions for good collaborative care. First it makes the assumptions of an interdisciplinary team, its composition and its goals. The Guidelines state: Palliative care presupposes indications for, and provision of, interdisciplinary team evaluation and treatment in selected cases. The palliative care team must be skilled in care of the patient population to be served. Palliative care teams may be expanded to include a range of professionals, based on the services needed. They include a core group of professionals from medicine, nursing and social work, and may include some combination of volunteer coordinators, bereavement coordinators, chaplains, psychologists, pharmacists, nursing assistants and home attendants, dietitians, physical-, occupational-, art-, play-, music-, and child-life-therapists, case managers and trained volunteers.
Moreover, good collaboration results in care across the health care spectrum. Specifically, genuine coordination of care across settings is ensured through regular and high-quality communication between providers at times of transition or changing needs, and through effective continuity of care and case management.
In the United States, collaborative practice is very different in a hospice setting and the palliative care setting. Since hospice is defined by federal guidelines of the United States Government, hospice care focuses on care in the home during the last six months of life, Since in the 1970s, hospice was championed in the United States by the nursing pioneer Florence Wald, hospice is nurse driven. Palliative care tends to be more hospital based and therefore is more physician driven. Thus, collaboration looks different in these two settings. Nonetheless, there are some common strategies to collaboration. This session will explore those strategies.
|