Article Text
Abstract
Background Developing and implementing an effective palliative care programme is a strategic priority. Madrid's first PC Unit opened in 1991, within mainstream heath system. 2005 saw an important impulse to PC Teams for a 6.5 m population. 2008–2010 was a period during which to consolidate and develop PC with a strategic plan to stress appropriately trained multidisciplinary teams, robust organisative and clinical models.
Aim To assess whether Madrid's interpretation of the traditional British model is fit for purpose.
Method Our model of care (UIMCP), for a population of 1m, incorporates ‘all the services patient and family may need to meet -expertly and timely- their palliative care needs’ with 24 h access to patient's information and uninterrupted access to palliative human and structural resources and collaboration from Primary Care, Hospitals, Independent sector, Patients Liaison Services and Information Systems under Palliative Care Department leadership. Implementation is gradual due to the huge professional training needs and complex integration of technical systems. Evaluation through structure, process and output indicators, cross sectional assessments is regular. Data are continuously collected, analysed by the Regional PC Observatory.
Results and Conclusions All A99 (terminal illness), episodes programmed activities and telephone calls are recorded. Several 100 protocols have been created including Adult and Paediatric referral forms, Pain (assessment), nursing plans, SD, out of hours calls. (1) Preliminary data show the effectiveness of a seamless clinical model. (2) 24 h specialist PC makes a huge impact on this population. (3) It achieves strategic regional goals ϖ organising all end of life services and resources ϖ setting all technological advances at the service of its population ϖ offering a seamless, wall-less pc clinical unit. (4) Adapting and translating the British hospice/specialist PC Unit to our own reality seems to be successful but only possible by electronic palliative care records.