May 2023

In January 2023 I started as a PHD candidate on the Pal-Cycles project. With an educational background focusing on international policy making and healthcare organization and management, I developed a fascination for solving problems through policies or interventions, and what makes them effective or not. More specifically I am interested in what can be done from an organizational point of view to improve people’s quality of life.

Observed from an organizational point of view, a rocky road is often experienced by patients with advanced cancer moving from curative care to palliative care. Ineffective communication between the afore mentioned settings induces misunderstandings regarding for example the treatment goals or responsibilities. These misunderstandings often cause patients to experience adverse events and preventable hospital admissions, which have a negative impact on their quality of life.

In the Pal-Cycles research project we aim to develop a programme to improve the transition from curative care to palliative care for cancer patients, applicable in seven different European countries (The Netherlands, Germany, United Kingdom, Poland, Hungary, Romania, and Portugal).

The research team is developing the Pal-Cycles programme, based on the following five cornerstones.

1. Identification of a patient with palliative and supportive care needs in collaboration with their oncologist and the hospital palliative care team.
2. Compassionate communication towards the patient and their family.
3. A collaborative multidimensional care plan and follow-up in the home care setting.
4. Timely evaluation of the care plan with patients and relatives.
5. Identification of the terminal phase (if reached) based on periodic evaluations, with appropriate intensification of care and end-of-life talks depending on local possibilities and habits, including consultation with patients and families about ethically and legally sensitive issues.

The Pal-Cycles programme will be tested for effectiveness using a stepped wedge clinical trial.  Patients will participate in the trial for five months. In addition to the effectiveness being tested, the implementation process and the ethics of the Pal-Cycles will also be evaluated. By doing this, we hope that in five years, we will be able to share whether the systemic changes made through the programme were effective in reducing unplanned admissions at the end of life and improving quality of life of patients and relatives.