Skip to main content
Top
Published in: Current Oncology Reports 6/2021

01-06-2021 | Care | Palliative Medicine (A Jatoi, Section Editor)

Organizational Strategies for Providing Cancer Palliative Care to Many

Authors: Arunangshu Ghoshal, Anuja Damani, Jayita Deodhar, Mary Ann Muckaden

Published in: Current Oncology Reports | Issue 6/2021

Login to get access

Abstract

Purpose

Hospitals and healthcare organizations are today operating in an extremely competitive environment, with increasing pressure to improve quality while reducing costs. In responding to this dynamic situation, transformation of any organization requires the will to organize delivery around the needs of patients.

Recent Findings

Providing palliative care to the many who require it needs the value agenda to be formulated based on mutually reinforcing components. Here we present an overview of the framework for a palliative care department in a comprehensive cancer center, which includes different levels that are embedded within a comprehensive system. Detailed information on each level is presented, followed by a discussion of quality of care, as an integrating theme for the framework.

Summary

The chapter concludes by detailing the benefits that a comprehensive cancer palliative care center provides to a country’s healthcare efforts through service, education, research, and advocacy.
Literature
1.
go back to reference International Atomic Energy Agency (IAEA). Inequity in cancer care: a global perspective. 2011. International Atomic Energy Agency (IAEA). Inequity in cancer care: a global perspective. 2011.
2.
go back to reference Hui D, Bruera E. Integrating palliative care into the trajectory of cancer care. Nat Rev Clin Oncol. 2016;13:159–71.CrossRef Hui D, Bruera E. Integrating palliative care into the trajectory of cancer care. Nat Rev Clin Oncol. 2016;13:159–71.CrossRef
4.
go back to reference Knaul FM. The global cancer divide: an equity imperative. Closing cancer divid. an equity imp. 2012. Knaul FM. The global cancer divide: an equity imperative. Closing cancer divid. an equity imp. 2012.
5.
go back to reference Aldridge MD, Hasselaar J, Garralda E, van der Eerden M, Stevenson D, McKendrick K, et al. Education, implementation, and policy barriers to greater integration of palliative care: a literature review. Palliat Med. 2016;30:224–39.CrossRef Aldridge MD, Hasselaar J, Garralda E, van der Eerden M, Stevenson D, McKendrick K, et al. Education, implementation, and policy barriers to greater integration of palliative care: a literature review. Palliat Med. 2016;30:224–39.CrossRef
7.
go back to reference Lynch T, Connor S, Clark D. Mapping levels of palliative care development: a global update. J Pain Symptom Manag. 2013;45:1094–106.CrossRef Lynch T, Connor S, Clark D. Mapping levels of palliative care development: a global update. J Pain Symptom Manag. 2013;45:1094–106.CrossRef
8.
go back to reference •• Prinja S, Downey LE, Gauba VK, Swaminathan S. Health technology assessment for policy making in india: current scenario and way forward. Pharmacoecon Open. 2018;2:1–3 The Government of India is in the process of establishing a medical technology assessment board, which will be the central agency for undertaking Health Technology Assessment in India. HTA works for utilizing health economic principles to comparatively assess evidence for cost, clinical effectiveness, safety, and equity to provide evidence as to whether an intervention is a cost-effective investment within a given health system and to assist in the prioritization of health resources.CrossRef •• Prinja S, Downey LE, Gauba VK, Swaminathan S. Health technology assessment for policy making in india: current scenario and way forward. Pharmacoecon Open. 2018;2:1–3 The Government of India is in the process of establishing a medical technology assessment board, which will be the central agency for undertaking Health Technology Assessment in India. HTA works for utilizing health economic principles to comparatively assess evidence for cost, clinical effectiveness, safety, and equity to provide evidence as to whether an intervention is a cost-effective investment within a given health system and to assist in the prioritization of health resources.CrossRef
9.
go back to reference Elsayem A, Swint K, Fisch MJ, Palmer JL, Ready S, Walker P, et al. Palliative care inpatient service in a comprehensive cancer center: clinical and financial outcomes. J Clin Oncol. 2004;22:2008–14.CrossRef Elsayem A, Swint K, Fisch MJ, Palmer JL, Ready S, Walker P, et al. Palliative care inpatient service in a comprehensive cancer center: clinical and financial outcomes. J Clin Oncol. 2004;22:2008–14.CrossRef
10.
go back to reference Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines. Potential benefits, limitations, and harms of clinical guidelines. Br Med J. 1999;318:527–30.CrossRef Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines. Potential benefits, limitations, and harms of clinical guidelines. Br Med J. 1999;318:527–30.CrossRef
11.
go back to reference 9th annual conference on evidence based management of cancers in India. 2011. 2010291 9th annual conference on evidence based management of cancers in India. 2011. 2010291
13.
go back to reference •• Macrae MC, Fazal O, O’Donovan J. Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature. BMJ Glob Health. 2020. https://doi.org/10.1136/bmjgh-2020-002368Community health workers have important roles in the provision of palliative care in Low Middle Income Countries. From the 13 studies included in this review, CHWs appear to have a role in raising awareness and identifying individuals requiring palliative care in the community, therapeutic management of pain, holistic home-based care delivery and visitation, and provision of psychological support and spiritual guidance. •• Macrae MC, Fazal O, O’Donovan J. Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature. BMJ Glob Health. 2020. https://​doi.​org/​10.​1136/​bmjgh-2020-002368Community health workers have important roles in the provision of palliative care in Low Middle Income Countries. From the 13 studies included in this review, CHWs appear to have a role in raising awareness and identifying individuals requiring palliative care in the community, therapeutic management of pain, holistic home-based care delivery and visitation, and provision of psychological support and spiritual guidance.
17.
go back to reference Berkman C, Stein GL, Glajchen M. Palliative and end-of-life care. Health and Social Work: Practice, Policy, and Research. 2018;145–168. Berkman C, Stein GL, Glajchen M. Palliative and end-of-life care. Health and Social Work: Practice, Policy, and Research. 2018;145–168.
18.
22.
go back to reference Stone PW. Integration of infection management and palliative care in nursing homes: an understudied issue. Res Gerontol Nurs. 2017;10:199–204.CrossRef Stone PW. Integration of infection management and palliative care in nursing homes: an understudied issue. Res Gerontol Nurs. 2017;10:199–204.CrossRef
24.
go back to reference • Rajagopal MR. Methadone is now available in India: is the long battle over? Indian J Palliat Care. 2018. https://doi.org/10.4103/IJPC.IJPC_201_17Morphine and fentanyl had so far been the only available opioids in India in step three of the World Health Organization analgesic ladder. Especially for those not tolerating morphine and particularly for those developing neurotoxicity, an inexpensive alternative, Methadone is available for sale in India for pain management. However, the characteristic pharmacokinetics and pharmacodynamics of methadone raise careful usage. • Rajagopal MR. Methadone is now available in India: is the long battle over? Indian J Palliat Care. 2018. https://​doi.​org/​10.​4103/​IJPC.​IJPC_​201_​17Morphine and fentanyl had so far been the only available opioids in India in step three of the World Health Organization analgesic ladder. Especially for those not tolerating morphine and particularly for those developing neurotoxicity, an inexpensive alternative, Methadone is available for sale in India for pain management. However, the characteristic pharmacokinetics and pharmacodynamics of methadone raise careful usage.
Metadata
Title
Organizational Strategies for Providing Cancer Palliative Care to Many
Authors
Arunangshu Ghoshal
Anuja Damani
Jayita Deodhar
Mary Ann Muckaden
Publication date
01-06-2021
Publisher
Springer US
Keyword
Care
Published in
Current Oncology Reports / Issue 6/2021
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-021-01061-7

Other articles of this Issue 6/2021

Current Oncology Reports 6/2021 Go to the issue

Neuroendocrine Neoplasms (NS Reed, Section Editor)

Update on Histological Reporting Changes in Neuroendocrine Neoplasms

Orthopedic Oncology (JA Abraham, Section Editor)

Update on Osteosarcoma

Leukemia (A Aguayo, Section Editor)

Erythroleukemia: an Update

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine