Western Health (WH) and Mercy Palliative Care (MPC) have established a successful Outreach Program, supporting WH palliative patients in the community. The development of a symptom management clinic at Western Hospital will build on and enhance this initiative.
Between 2000 and 2009, the population of Melbourne’s western region increased by 29% from 927,464.1 WH Palliative Care Consultancy service predicts a 16% increase in activity over the next 12 months.
An innovative approach to this growth has been formulated.
The WH Palliative Care Team identified gaps in service provision for oncology patients who are seen almost exclusively as outpatients but who have symptoms that could benefit from palliative care involvement, particularly community palliative care. MPC has also identified an increasing number of referrals from oncology who could benefit by earlier palliative care involvement.
By improving the integration of care between hospital and community services, the SMART ( Symptom Management Assessment and Referral Team) Clinic aims to provide an alternate patient pathway through timely, appropriate and consistent symptom relief, information and psychological/spiritual support. The aim is to ensure people’s needs are met in their place choice.
The Clinic involves disciplines and services such as Palliative Medicine Consultants, Clinical Pharmacy, Community and Hospital based Clinical Nurse Consultant’s (CNC) and Allied Health.
The project aimed to introduce new roles and responsibilities into care pathways such as pharmacy and community based specialist nursing, to provide services beyond the hospital walls.
The Clinic supports three of the four current WCMICS key priority areas.
Patient,carers, hospital referal sources, general practitioners and MPC nurses report positive out comes with respect to symptom control and patient experience. Of the 23 deaths, 43% were at home, 39% in Palliative Care Units and 17% in acute hospital beds. A trend to reduction in emergency presentations of patients seen in SMART Clinc has also been identified.