2017 IAPCON Abstracts
Indian Journal of Palliative Care(2017)
摘要
Indian Journal of Palliative Care ¦ Volume 23 ¦ Issue 2 ¦ April-June 2017 122 Introduction: Death is inevitable but the manner in which a person dies is fundamental to the person concerned and their nearest and dearest. The effects of poor care leading to death are distressing for patients and also have long term effects for those closest to the patient. Sadly, end of life care remains under resourced and funded not only in terms of service provision but equally in research funding. This paper describes the work of a group of committed International health care professionals whose mission is to improve the care for the dying by sharing their knowledge expertise and engaging in Collaborative innovation research and education. The group, known as The International Collaborative for Best Care for the Dying Person was officially formed in January 2014. The Coordinating Centre for the Collaborative is based at the Marie Curie Palliative Care Institute Liverpool (MCPCIL), University of Liverpool, UK. Collaborative Vision: The vision of the Collaborative is for a world where all people experience a good death as an integral part of their individual life, supported by the very best personalised care. Background of the Collaborative: An international meeting was held in Liverpool, UK, November 2013, attended by leading thinkers, practitioners, and researchers in care for the dying from 12 countries. The group had been working together for a number of years with a shared focus on the Liverpool Care Pathway for the Dying Patient (LCP) International Continuous Quality Improvement Programme[1] to drive up the quality for care for the dying in the last few days and hours of life at the clinical interface. In 2009 the LCP became the focus of the societal debate across print and broadcast media in England. Despite a randomized control trial (RCT) in Italy which, although underpowered, found an overall improvement for patients who were cared for in wards where the LCP was used (Costantini et al., 2014),[2] and the finding of the Neuberger Review into the LCP,[3] which highlighted the ethical basis of the LCP and its efficacy when used appropriately, the LCP was withdrawn from use in England with effect from July 2014. The international group had also been working together on a wider suite of work packages related to research and development and knowledge transfer related to care for the dying person. The group was successful in securing funding by an EU FP7 Co-ordination and Support Action grant of €2.2million to optimise research for the care of cancer patients in the last days of life. This collaborating project was called OPCARE9. OPCARE9 generated a series of research protocols for further research and development, which have been taken forward within the Key Research and Development arm of our International Collaborative. A final Dissemination Conference involving over 300 multi-professional delegates worldwide, and a high profile international Policy Summit, presented findings of best practice, key issues, and themes from OPCARE9, which was attended by senior governmental and clinical practitioners from the 9 countries of the project. To take forward this work it was agreed in November 2013 to establish ‘The International Collaborative for Best Care for the Dying Person’, taking our collaborative of leading international experts and researchers forward in a renewed focus on the international evidence and the next steps in improving care for dying patients and their families. This has strengthened worldwide commitment and capacity to undertake high quality, robust research, to utilise service innovation and improvement methodology, evaluation, and knowledge transfer to improve care for the dying in the 21st Century on a global basis. The Collaborative was formally launched in January 2014 and its first International Conference was held in Lund, Sweden in November 2014. A constitution was agreed and an executive committee established. The Chair of the Collaborative is John Ellershaw Professor of Palliative Medicine University of Liverpool and the executive committee has representatives from seven countries. The Objectives of the Collaborative: The collaborative will • Build on, extend, and foster the Collaborative working relationship established during the OPCARE9 EU 7th Framework Project guided by the principles of the Collaborative for Best Care for the Dying Person • Drive forward an international ‘care for the dying’ research agenda and to undertake collaborative international research • Encourage international learning and teaching collaborations to improve the care for the dying • Set, articulate and nurture care for the dying related values, quality indicators, obligations, and strategic aims across the international clinical community • Provide an international platform for health professionals to communicate with each other to improve the care for the dying • To support the development of an “international programme” and associated materials and processes within a five-year Quality Assurance Cycle • Develop an effective communication strategy across international partners to enable innovative growth in support of dynamic international care for the dying work streams acknowledging, disseminating, and celebrating success • Develop and take part in societal debate about care for the dying person and the wider issues of death and dying in society • Hold an Annual General Meeting • Hold an Annual International Conference. The Work of the Collaborative: The work of the Collaborative incorporates project groups around four main themes: • The International Programme • Research and Development • Learning and Teaching • Quality assurance. The International Programme incorporates core clinical guidance derived from the International 10 Principles and the International Core Elements for Best Care for the Dying Person[4] that enables effective engagement at the clinical interface supported by a robust implementation and dissemination process for translation of best care to the bedside. This Programme is at the heart of what the Collaborative does. If member organisations wish, they are free to submit their care plan to the Executive committee for congruence assessment against the Internationally agreed guidance. If congruent the organisation is able to badge their document with the Collaborative logo. The Research and Development theme incorporates project groups to strengthen worldwide commitment and capacity to undertake high quality, robust research in this complex, critical area of care. This includes a range of cross cutting themes and methodologies including quality outcomes and indicators. The Collaborative will enable valid, reliable and transferable evidence to be generated, supporting important developments and advances in clinical practice and policy. Collaborative partners have recently been successful in securing an ERANET LAC research grant, for a proposal submitted by Professor Dagny Faksvag Haugen from Norway on
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