Defining the palliative care population – a needs based model s. 13
A population based service planning approach seeks to understand and plan for the health needs of the target population as a whole, and to implement and evaluate interventions to improve the health or well being of that population. In population based approaches to care delivery, individual patient care is provided within the context of the culture, health status and health needs of the entire population of which that patient is a member. When planning care for a population, as distinct from caring for an individual member of that population, health services are accountable for measuring outcomes for all members of the targeted population, including those who may not, for a variety of reasons, access services.
Describing the sub-groups s. 16-17
Sub-Group A
The largest sub-group (A) is those patients who do not require access to specialist care to meet their needs which are met either through their own resources or with the support of primary care providers, (for example generalist medical and nursing services as well as other specialist staff – oncologists, cardiac services, geriatricians and so on).
Sub-Group B
Some patients with a life limiting illness will have sporadic exacerbations of pain or other symptoms or may experience social or emotional distress. These patients may have a temporary increase in their level of need and may require access to specialist palliative care services for consultation and advice. They will continue to receive care from their primary care provider.
Sub-Group C
Palliative care patients who have the greatest needs are often those with complex physical, social, psychological and/or spiritual needs that do not respond to simple or established protocols of care. These patients represent a variable but minor proportion of all those people who are living with a life limiting illness. They usually require highly individualized care plans developed, implemented and evaluated by knowledgeable and skilled specialist practitioners, in partnership with primary care providers.
Community and public health initiatives in palliative care s. 26
Where death, dying, loss and grief are concerned, there is potential for everyone in the community to be affected. Palliative care and health promotion providers may work with workplaces, schools, clubs, trade unions and local government to design joint programs that increase public awareness of topics of importance to dying people, their primary carers and families.
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