ABSTRACT
The context and constraints of modern medicine (hospital beds and caregivers' reductions, ambulatory shift, new therapeutic approaches, integration of supportive care ) combined with new societal and Health system changes (ageing population, chronic diseases, new requirements of the patients ) redefine the orientations of care and question professional practices. The participative approach (PA) as a model of team organization proposes solutions involving the skills of the various interacting caregivers and experimental knowledge and consideration of patient needs. The multi-professional staff (MPS) is a collaborative tool of this participative approach that federates a team around a health or care project personalized from the crosschecked eyes of care professionals and from a shared decision-making process. Its objective is to combine the improvement of quality of care with quality of life at work. It requires a transversal mindset of teams, intrinsic values and specific characteristics. Its organization is simple but requires some rules and we will develop the main steps to success. This article, which is the result of a joint reflection and experience of health professionals, shows the principles and wants to demonstrate the weakness of MPS. The interest of the French National Cancer Institute for this collaborative tool is an asset for further work in the perspective of generalization of MPS for all patients with chronic disease and not only for patients at palliative phase.
Subject(s)
Guidelines as Topic , Health Care Sector/organization & administration , Health Personnel/organization & administration , Neoplasms/therapy , Personnel Staffing and Scheduling/organization & administration , Decision Making, Shared , Humans , Patient Care Team/organization & administration , Quality Improvement , Quality of LifeABSTRACT
Shared medical decision-making is a complex process, especially with regard to the withdrawal of specific treatments in oncology. On the one hand, patients, particularly vulnerable due to their advanced disease, and their family, apprehend this withdrawal. On the other hand, oncologists have more and more treatment options available to them thanks to the medical advances made over recent years. An observational prospective study was carried out in oncology. It focused on the motives which led to the question of treatment withdrawal being raised, to the degree of agreement between the different parties (palliative care team, oncologist, patients and families) and on the final decision.
Subject(s)
Decision Making , Neoplasms/therapy , Withholding Treatment , Humans , Prospective StudiesABSTRACT
The mobile continuous care and support team works with patients receiving palliative care. The palliative care day hospital, a new place of life, offers space and time to respond to the needs of the patient and his/her family in an approach which blends technical aspects and support.
