Abstracts by keywords: palliative care
The concept of quality has become increasingly important in the healthcare sector in recent years. One area of healthcare that has specific quality requirements is palliative care (PC). PC refers to the age-independent, active and holistic care of seriously ill people, especially at the end of life (Radbruch et al. 2020). This includes the identification of palliative needs, (advance) planning of care and interventions for holistic symptom control (Downar et al. 2019) with the aim of improving the quality of life of patients and relatives (Radbruch et al. 2020). In Germany, palliative care for palliative patients in more stable phases of the illness is provided on an outpatient basis, supported by general practitioners and specialists, general outpatient palliative care teams (AAPV) or specialized outpatient palliative care teams (SAPV). If the burden of symptoms increases, you may be admitted to a palliative care unit. Hospice services and hospices exist across sectors (Simon et al. 2016). Interest in measuring and increasing the quality of care is also constantly increasing in PC: In 2004, the National Consensus Project for Quality Palliative Care (NCP) created guidelines for eight quality-critical areas in PC (2004). These constantly updated guidelines are intended to support those involved in healthcare to use treatment principles and best practice examples in their treatment to ensure high-quality PC for all people with life-limiting illnesses and their relatives, regardless of the respective setting, diagnosis, prognosis or age to enable (Ferrell et al. 2018).
22.09.2021
According to estimates, there are currently around 4 million people living in Germany who have already suffered from cancer in the course of their lives, and around 500,000 people are diagnosed with cancer every year (RKI/GEKID 2019). Thanks to numerous innovations in diagnostics and therapy, the treatment of cancer is now associated with better chances of survival, but has also become more complex. While previously the three pillars of cancer therapy were usually referred to (surgery, radiotherapy and chemotherapy), today five treatment modalities are assumed: surgery, radiotherapy, chemotherapy, targeted therapy and immunotherapy (Weber 2018). Multidisciplinary and intersectoral case discussions with representatives of various specialist disciplines (in particular surgery, pathology, radiology, oncology) in tumor conferences, tumor boards, consultations or forums with the aim of making a common treatment recommendation are a central part of the qualified care of patients with complex oncological diseases. In particular, the terms “tumor conference” and “tumor board” are often used interchangeably. The consultation and decision-making processes that take place as part of the multidisciplinary tumor conferences (MTK) have a significant influence on the diagnostic and therapeutic measures initiated (Basta et al. 2017; Hermes-Moll et al. 2016). Studies have shown that MTK can improve diagnostic reliability and clinical outcomes (Basta et al. 2017; Lamb et al. 2011). Some studies suggest that case discussion in MTK is positively associated with longer survival (Hong et al. 2010; Kesson et al. 2012; Pillay et al. 2016). But there are also isolated study results that suggest no improvement in therapy or prolongation of overall survival through a discussion in MTK (Specchia et al. 2020; Keating et al. 2013; Kee et al. 2004). A high-quality MTK recommendation can therefore have a lasting impact on the care, quality of life and survival of sick people - and ultimately also on the costs of the healthcare system.
22.09.2021
The importance of holistic, cross-sector care concepts and the associated requirements for the daily work of medical and nursing service providers are in a continuous process of change. New forms of care, intersectoral cooperation and process optimization measures are a central component and at the same time the basis of modern patient care. A transfer of information and knowledge related to these circumstances thus becomes a critical factor for the final quality of the service provision and its maximum possible care efficiency [1]. Building on this, new, complex requirements for technical work tools and communication media are developing, which meaningfully complement existing supply structures or even take on a central cross-sectional function [2, 3]. The influence of electronic procedures increases exponentially as soon as sectoral boundaries are broken particularly frequently in a still fragmented care system, large spatial distances have to be overcome or intersectoral cooperation becomes particularly important in terms of treatment success [3, 4]. All of these factors are of central importance, especially for the design of new and information-intensive forms of care within the meaning of the Fifth Social Security Code (Table 1) [5]. Information and communication technology (ICT) solutions must demonstrate the potential here to better meet the current and future challenges in the healthcare system [6, 7] [8] and at the same time sustainably increase quality and cost-effectiveness [1, 3, 9]