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Published byEustace Phillips Modified over 9 years ago
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The EPEC-O Curriculum is produced by the EPEC TM Project with major funding provided by NCI, with supplemental funding provided by the Lance Armstrong Foundation. Education in Palliative and End-of-life Care - Oncology The Project EPEC-O TM
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EPECEPECOOEPECEPECOOO EPECEPECOOEPECEPECOOO Plenary 2 Models of Comprehensive Care Plenary 2 Models of Comprehensive Care EPEC - Oncology Education in Palliative and End-of-life Care - Oncology
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Main message l Funding and service delivery systems must be in place to provide palliative care as a reliable component of comprehensive cancer care
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Objectives l Comprehensive cancer care includes palliative care from the day of diagnosis l Define hospice and palliative care and relate their history l Describe funding and service delivery models for providing comprehensive cancer care l Understand when palliative care services are appropriate for cancer patients l Comprehensive cancer care includes palliative care from the day of diagnosis l Define hospice and palliative care and relate their history l Describe funding and service delivery models for providing comprehensive cancer care l Understand when palliative care services are appropriate for cancer patients
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Video
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Comprehensive cancer care l Gaps in contemporary cancer care l Approaches to relief of suffering Piloted with hospice programs More widely applied through palliative care programs Now being integrated into comprehensive cancer care l Gaps in contemporary cancer care l Approaches to relief of suffering Piloted with hospice programs More widely applied through palliative care programs Now being integrated into comprehensive cancer care
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Hospice l Historical evolution l Medicare Hospice Benefit 40% of dying cancer patients referred Median enrollment 22 days 37% of patients die within 7 days l Historical evolution l Medicare Hospice Benefit 40% of dying cancer patients referred Median enrollment 22 days 37% of patients die within 7 days
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Conventional cancer care
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Hospice in the US today l A place l An organization or program l An approach to or philosophy of care l A system of reimbursement l A place l An organization or program l An approach to or philosophy of care l A system of reimbursement
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Hospice care
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l Safe and comfortable dying l Self-determined life closure l Effective grieving l Safe and comfortable dying l Self-determined life closure l Effective grieving
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Levels of care l Routine care l General inpatient care l Continuous care l Respite care l Routine care l General inpatient care l Continuous care l Respite care
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Core services l Interdisciplinary care Chaplaincy, nursing, medical social services, counseling, volunteers Primary care physician Palliative care physician (consultation) l Bereavement counseling l Medical equipment, supplies l Medications and therapies related to the terminal diagnosis l Interdisciplinary care Chaplaincy, nursing, medical social services, counseling, volunteers Primary care physician Palliative care physician (consultation) l Bereavement counseling l Medical equipment, supplies l Medications and therapies related to the terminal diagnosis
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Palliative care l Therapies to relieve suffering and improve quality of life l May be combined with therapies aimed at remitting or curing cancer, or it may be the total focus of care l Therapies to relieve suffering and improve quality of life l May be combined with therapies aimed at remitting or curing cancer, or it may be the total focus of care
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WHO 2002 definition of palliative care "Palliative care is an approach which improves quality of life of patients and their families facing life- threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual"
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Palliative care
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Delivering palliative care PrimaryPrimary SecondarySecondary TertiaryTertiary
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Comprehensive cancer care l Anti-cancer therapy l Supportive care l End-of-life care l Bereavement care l Anti-cancer therapy l Supportive care l End-of-life care l Bereavement care
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Comprehensive cancer care
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Clinical (secondary) palliative care ConsultationServicesConsultationServices InpatientCareInpatientCare HomeHome OutpatientOfficeOutpatientOffice SNFSNF
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Case examples l Warren Grant Magnuson Clinical Center, NIH, Bethesda l Memorial Sloan-Kettering, NYC l Dana-Farber Cancer Center, Boston l Fox Chase Cancer Center, Philadelphia l MD Anderson Cancer Center, Houston l Warren Grant Magnuson Clinical Center, NIH, Bethesda l Memorial Sloan-Kettering, NYC l Dana-Farber Cancer Center, Boston l Fox Chase Cancer Center, Philadelphia l MD Anderson Cancer Center, Houston
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Development as a specialty l Curricula l Certification exams l Journals l Textbooks l Fellowship training l Formal recognition as a subspecialty l Curricula l Certification exams l Journals l Textbooks l Fellowship training l Formal recognition as a subspecialty
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EPECEPECOOEPECEPECOOO EPECEPECOOEPECEPECOOO Summary Funding and service delivery systems must be in place to provide palliative care as a reliable component of comprehensive cancer care Summary Funding and service delivery systems must be in place to provide palliative care as a reliable component of comprehensive cancer care
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