Team-based models for end-of-life care: an evidence-based analysis
Health Quality Ontario
Record ID 32015000094
English
Authors' recommendations:
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
URL for published report:
http://www.hqontario.ca/Portals/0/Documents/eds/ohtas/eba-eol-team-based-models-1411-en.pdf
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.