Transitional Palliative Care – A novel programme to ensure good continuity of care at home On Friday 4th November, the Pal-Cycles research group met in
What is Pal-Cycles?
A project funded by the European Commission (grant agreement N°101057243) that aims to find the optimal transition model between the hospital and home.
Led by Prof Jeroen Hasselaar from Radboud University Medical Center Nijmegen (The Netherlands), this programme will facilitate patient-centred communication and continuity of care for people with advanced cancer, reducing unplanned hospital admissions and improving quality of life at the end of life.
What are the specific needs that triggered this project?
There are around 1.5 million people with cancer in Europe who need palliative care. People with advanced cancer continue to be discharged from hospitals with no guarantee of continuity of care at home. Unclear communication and the lack of a joint functional network between the hospital and the professional community make the transition from hospital discharge to home difficult. The identification and management of resources necessary for a good continuity of care fails, resulting in an unsettling situation for patients and families.
Unfortunately, a palliative care team is often not involved in the discharge from hospital in situations of advanced and severe illness. This may hinder a personalised, holistic care planning, focused on the specific needs of the people who require this care.
The time has come to find a real and feasible strategy to involve community health care providers (family doctors and nurses) at the time of hospital discharge. This strategy, thought out in an innovative way, can guarantee the quality of care at home. In addition, it may contribute to a better management of the health system, avoiding unnecessary and frequent readmissions to the hospital emergency department.
The Pal-cycles programme is designed to connect people, improve the quality of care and therefore the quality of life for people dealing with advanced cancer, whether they are patients, family carers or healthcare providers.
“The Pal-Cycles research group wants all people with advanced cancer disease and their relatives, to be guaranteed continuity of care at home, in a functional and organised way, ensuring quality of care and the well-being of all”