Team-based models for end-of-life care: an evidence-based analysis

Health Quality Ontario
Record ID 32015000094
English
Authors' recomendations: In our systematic review of team-based end-of-life care, we looked at care provided by teams that included, at minimum, a physician and a nurse, at least one of whom was specialized or experienced in end-of-life health care. Team services included symptom management, psychosocial care, development of patient care plans, end-of-life care planning, and coordination of care. The following findings apply to models of team-based end-of-life care used to deliver care to people with an estimated survival of up to 24 months. Comprehensive Team-Based Model There is moderate-quality evidence that a comprehensive team-based model with direct patient contact significantly: • improves patient QOL, symptom management, and patient and informal caregiver satisfaction; • increases the patient's likelihood of dying at home; • decreases the patient's likelihood of dying in a nursing home; and • has no impact on hospital admissions or hospital length of stay. Hospital Team-Based Model There is moderate-quality evidence that a hospital team-based model with direct patient contact has no impact on length of hospital stay. There is low-quality evidence that this model significantly reduces ICU admissions. Home Team-Based Model There is low-quality evidence that a home team-based model with direct patient contact: -significantly increases patient satisfaction, and increases the patient's likelihood of dying at home; and - significantly decreases emergency department visits and hospital admissions. Team Membership and Services Team membership includes at minimum a physician and nurse, one of whom is specialized or experienced in end-of-life health care. Team services include: - symptom management - psychosocial care - development of patient care plans - end-of-life care planning - coordination of care
Details
Project Status: Completed
Year Published: 2014
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Palliative Care
  • Terminal Care
  • Critical Care
  • Critical Illness
  • Critical Pathways
  • Death
  • Patient Care Team
  • Patient Care Planning
  • Time Factors
  • Hospitalization
Contact
Organisation Name: Health Quality Ontario
Contact Address: Evidence Development and Standards, Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario Canada M5S 1N5
Contact Name: EDSinfo@hqontario.ca
Contact Email: OH-HQO_hta-reg@ontariohealth.ca
Copyright: Health Quality Ontario
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.