Seamless Pc Thepenangmodel_datoseridrtdevaraj

HOSPICE AT HOME PROGRAMME

SEAMLESS P C – THE PENANG MODEL Dato Seri Dr T Devaraj CEO / Medical Director Rumah Hospis Pulau Pinang

RUMAH HOSPIS PULAU PINANG

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Established 1992 4570 patients (1992 - 2007) 150 patients at any one time Up to 90 live Seberang Jaya 80 % die at home

RUMAH HOSPIS PULAU PINANG ¾ Opened 2001 ¾ Eight beds ¾ License from MOH ¾ Admissions

591 (2001(2001-2007) patients ¾ Average duration of stay 7 days ¾ Referral sources - 60 % HHP 40 % Hospitals ¾ Number died 225

“SHORT TERM ININ-PATIENT SERVICE” SERVICE” *Symptom control *Procedures *Respite care *Social *Others

SEAMLESS PC IN PNG ¾ Unique for an NGO ¾ Resource constraints (inpatient service) ¾ Hospice programmes not part of

health care system ¾ Some public wants – long term stay “treatment’ treatment’ transport free service

EXAMPLES OF SEAMLESS PC PCU’ PCU’s Queen E Hospital Hospital BM Hospital Seremban Hospital Selayang

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EXISTING SCENARIO AND PROBLEMS

LOCAL SEAMLESS CARE MODELS ¾ ¾

ARE DISEASE SPECIFIC

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Lack of continuity of care within and between hospitals providing care and primary care givers Lack of knowledge and skills in PC amongst health care providers Attitude towards palliative care Lack of resources – manpower, infrainfra-structure, funds and facilities Lack of training in PC Inability to develop outreach programmes due to manpower constraints Dr Fauzi b Abdul Rani Pakar Perubatan Respiratori Hospital Sultanah Aminah Johor Bahru

VISION

STRATEGY ¾ To provide continuous care to cancer

TO PROVIDE A SEAMLESS PALLIATIVE CARE SERVICE IN THE STATE OF JOHORE BY THE YEAR 1999

patients once cure becomes an unrealistic goal

¾ To provide an integrated system of

palliative care for patients involving participation of hospital, family, primary health care providers and support groups

ROLE OF HEALTH CLINICS

SEAMLESS CARE ¾ Philosophy of care - primary care led and

¾ To integrate palliative care as part of

domicilliary nursing service ¾ May be possible due to good network of health facilities and staff ¾ Use of polyclinics as day care ¾ Adequate training required

community based ¾ Continuity of care between practice settings and levels of care ¾ Applies to many chronic conditions and chronic illnesses ¾ Main thrust of care still home care ¾ In patient care as back up

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SEAMLESS CARE REQUIREMENTS ¾ ¾ ¾ ¾

Shared vision of care Smooth and safe transition of PT between hospital/home Networking Communication - right flow of information, right time, right person Reality Check * abyss between levels of care * no safety net * CAM as confounding factor

EXPANDING SEAMLESS CARE ¾

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Urban areas * must have both home & in patient services * acceptance of need for continuum of care * good liaison between both services * shared information in best interests of PT * gray areas – medications, charges Rural areas * potential exists in Rural Health Service

EXPANDING SEAMLESS CARE IN PUBLIC SECTOR

HOSPITAL SUPPORT TEAM HEALTH SUPPORT TEAM

PT

SEAMLESS CARE

A GOAL OF GOOD MEDICAL PRACTICE

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