ABSTRACT
Background: Our Palliative Care Team (PCT) promotes integrated care between the hospital and home. Due to the COVID-19 pandemic, between the March 23 and May 2, the government declared a state of emergency. Aims: To analyse how the emergency period affected the performance of the team. Methods: Retrospective study comparing the delivery of care in hospital and at home during the emergency period and similar period in 2019. Statistical analysis used the SPSS programme, version 20. Results: In 2020, there were 96 attended patients (31 in-hospital and 65 domiciliary). In 2019, 100 patients were attended to (43 in-hospital and 57 domiciliary). Results comparing 2019 to 2010: In hospital, the average patient's age and the waiting time was similar (70.3 vs 70.6, P = .944;1.49 vs1.35 respectively, P = .73). Fewer women were attended (46.5% vs 25.8%, P = .057). The main causes for referral were pain and guidance of care (23% & 46.5% vs 12% & 67%). Most had oncological diseases (76.7% vs 83.9%, P = .32). Family conferences were similar (62.8% vs 64.5%, P = .53), although only 25% were face-to-face in 2020 (P = .001). There are more teleconsultations (0% vs 32%, P = .001) and psychological support (23% vs 51.6%, P = .012). The change in rate of hospital deaths was not significant (48.8% vs 61%, P = .205). In domiciliary care, patient's average age was similar (75 vs 74, P = .595) with no difference in gender (P = .289). The main disease remains oncological (63.2% vs 66.2%, P = .438). Teleconsultations increased (0% vs 27.7%, P = .003) and there was a reduction in face-to-face consultations (47.4% vs16.9%, P = .028). Mortality rate was similar (15.8% vs 18.5%, P = .812), but deaths at home decreased (66.7% vs 50%, P = .66). The psychological support was similar (15.8% vs 12.3%, P = .885). Conclusion: The way of delivering care was modified mainly by the use of electronic communication, but did not have implications in the type or the number of patients attended.
ABSTRACT
Background: Due to the COVID-19 pandemic, between March 23 and May 2, the government declared a state of emergency. To adjust the response to the expected incremental demand, our Palliative Care Team (PCT) adopted various policies. The PCT works in a suburban acute care hospital with 360 beds. It is the primary hospital for around 180,000 people, and it is the secondary reference for 300,000 people. During this period, one of the main problems was the lack of health care professionals, as they were infected by the virus or because their primary focus was with COVID-19 patients. Another problem was the necessary use of personal protecting equipment and the need to avoid dissemination of the virus. Therefore, direct patient evaluation has decreased. Regarding the necessary deliver of palliative care the team has assessed and provided for the extra need of drugs and materials, provided electronic devices as an alternative method of communication, established protocols regarding prevalent symptoms, referenced a palliative care professional in the COVID wards, provided psychological support to all patients and families and provided 24-h palliative care consultation. Aims: The aim of this work is to analyse how hospital doctors evaluated the support of the PCT. Methods: Delivered an online survey to doctors working in the wards of the medical department, questioning: the PCT protocols and if they have used it, the 24-h support of the PCT and if they have used it and how they evaluate the PCT performance. Results: The survey was delivered to 80 doctors with 19 responses. Most doctors worked directly with COVID-19 patients. About 64.7% of respondents have acknowledged the protocols and 63.6% used it;81.8% considered the protocols useful. Concerning the 24-h support, 53.8% knew about it and 30.8% used it. About 84.6% considered the performance of the PCT greater than 7/10. Conclusion: During the emergency pandemic period, the policies adopted by the PCT seem successful.