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Palliative Care in the Acute Hospital System

In Australia, the majority of deaths occur in general hospital wards. Most of these deaths are neither sudden nor unexpected. The Australian Institute of Health and Welfare (2006) reported
that over 50% of deaths occurred in a hospital, with only 11% of these occurring in a designated palliative care bed. Elderly people and 
those with multi-system disease form
the majority of in-hospital deaths. People who die without palliative care support may be in rural or regional centers, where access to a designated palliative care bed is difficult. It is only relatively recently that the need for palliative care services in acute hospitals has been acknowledged, and this chapter looks at how acute hospitals are focusing on the care of people with acute needs and those with reversible exacerbations of chronic illness. It discusses palliative care consult services and integrated care pathways. This chapter also offers case studies and a comprehensive reference list.

Contents include

  • the Australian context
  • the development of PCCS in acute hospitals
  • the operational logistics of PCCS
  • what is the difference in working in PCCS compared to inpatient palliative care units or home care?
  • ensuring sustainability
  • case studies.
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Author / Editor Biographies

Christine Mooney has worked as a Palliative Care Nurse Consultant at Southern Health since 2002. She has worked in a wide variety of settings, both in public and private, including at the Community Palliative Care and Inpatient Hospice in the United Kingdom. Christine has been the lead Project Officer for developing and implementing the Pathway for Improving the Care of the Dying (PICD) across the Southern Health network.
Kate is the Director of Supportive and Palliative Care at Southern Health and Monash University. She originally trained as an Anaesthetist and Intensivist and developed her interest in pain control and palliative care when working as an anaesthetist at the Peter MacCallum Cancer Centre. Her major interests and research are in refractory cancer pain and the role of palliative care consult services in general hospitals. Her major publications have been on cancer pain including 'Burst' ketamine and the development of the Pathway for Improving the Care of the Dying (PICD) to help disseminate the p...
RN. Palliative Care
Gabrielle O'Connor is the Manager of the Palliative Care Consult Service at Southern Health. She is also the Neuro-oncology Nurse at Southern Health. She established a country palliative care service, and has worked in community palliative care services in Melbourne prior to be employed at Southern Health. Gabrielle is extremely concerned about the caregiver burden of patients with cognitive deficit and the need for improved home respite for this group of people. Gabrielle has been part of the team that has been involved in the implementation of the Pathway for Improving the Care of the Dying ...

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