Dados do Trabalho

Título

IMPLEMENTATION OF A PALLIATIVE CARE SERVICE IN AN OPEN CLINICAL STAFF HOSPITAL: CHALLENGES, STRATEGIES AND RESULTS.

Introdução

The presence of a specialized palliative care service in hospital units has become essential, especially in the care of cancer patients. The adequate allocation of technological and therapeutic resources in care brings clear benefits not only for the patient, but also for the institutions.

Objetivo

This paper aims to describe and share the challenges and strategies of implementing a palliative care service in oncology in a general hospital, with an open and private clinical staff in Rio de Janeiro/Brazil

Método

This is a descriptive experience report on the implementation of the Palliative Care Service in Oncology in a general, private hospital from September 2019 to June 2021.

Resultado

Strategies such as multidisciplinary training of the institution's employees, wide divulgation of the service to the medical community that uses the hospital, replacement of the sector's name from "Palliative Care" to "Integrated Care" and especially the creation of automatic trigger criteria to activate the team - uncontrolled symptoms, active process of death, performance status ECOG> or = 3 or PPS< or = 50%, regardless of functionality: malignant bowel obstruction, head and neck cancer requiring tracheostomy or gastrostomy, primary or metastatic lesion in the central nervous system - contributed significantly to greater expression of the service in the institution. Since the implementation, data were collected on 208 patients treated by the Palliative Care Service, observing the main diagnostic groups, predominant age group, purpose and origin of the activation, indicated approach and outcome. Of the patients who died, 81% had their end of life managed outside closed units.

Conclusão

The implementation of a Palliative Care service requires continuing education strategies, divulgation of the sector's presence, demonstration of clear results in the quality of care, such as effective symptom control and communication tools that allow the definition of ADLs in a decisive manner, in addition to presenting relevant impacts for the management of hospital beds and spending on futile therapies, representing a measure that not only promotes greater quality of care, but also favors adequate allocation of resources. This model of implementation of the Oncology Palliative Care Service was a success and its strategies can be replicated in other institutions.

Palavras-chave

palliative care; hospital; implementation