The main objective of forming a palliative care hospice team is to provide Palliative care services to people.
Minimum structure of interdisciplinary team consists of: doctor, nurse, social worker and optionally: carers, psychologists, clergy, therapists (physical therapist, play therapist, occupational therapist, etc.), volunteers, other staff with appropriate clinical experience or education in the needs of palliative patients care.
Minimum palliative care staffing standards are:-
• The core team
- A doctor to 20-30 patients
- A palliative nurse at 10 to 15 patients
- A social worker to 50-60 patients
• Another optional personal
- A carer to 6-8 patients
- A psychologist on the team to 50-60 patients
- Cleric (employee or volunteer)
Staff should have appropriate qualifications in palliative care, as follows:
• Doctor: at least 3 years medical experience and specialization / expertise / certified in palliative care, certified member of the College of Physicians;
• Medical Assistant: graduate university / college / post high school, the right to free practice of palliative care in-depth course (6-8 weeks) / jurisdiction and supervision from a palliative nurse for 3-6 months;
• The social worker: degree in social work and palliative care course, 1 year experience as a social worker working with different groups, counseling experience;
• carer: supervised practice at least 3 months, palliative care course (2 weeks);
• Psychologist degree, certificate in counseling and / or psychotherapy specialist psychologist level (minimum 3 years experience), 1 year experience in health care, palliative care course starting in 2 weeks;
• Cleric / Priest / spiritual care coordinator: introductory course palliative care.
To ensure the quality of palliative care and good collaboration within the team, at least 75% of staff must be employed full time.
The average number of visits per day working for a doctor, palliative nurse and a social worker is 4. In children, depending on the range, number of visits may be correspondingly low.
Procedural issues :-
Palliative care at home will provide eligible beneficiaries without discrimination, regardless of age, sex, ethnicity, race, religion, social status, political beliefs.
Objective: Establish clear, well defined, the selection of beneficiaries measurable palliative care in their home. Because palliative care program and services are in an early stage of development will be considered eligible beneficiaries oncology patients, HIV / AIDS and children diagnosed with life-threatening disease or limited life prognosis as defined by ACT.
These standards will be reviewed periodically, with the development of palliative care services, with corresponding expansion of the category of beneficiaries.
- Adults beneficiaries of palliative care at home are people diagnosed incurable disease with limited life expectation and ECOG performance status of at least 3years .
- Pediatric palliative care services are provided to children and adolescents whose disease was diagnosed in childhood, methods according to ACT criteria:
- Diseases for which curative treatment is possible, but may fail (cancer, organ failure etc.).
- Diseases with limited prognosis in intensive treatment can improve quality of life (cystic fibrosis, neuromuscular dystrophy progressive, etc.).
- Progressive disease where palliative treatment is possible only at the beginning
- In adults the number of visits that can be performed by the patient on a multidisciplinary team of 100 initial recommendations with the possibility extended by one wrestled for 100 visits.