Introduction Palliative care services are engaging with patients earlier in their disease trajectory from an increasing range of life limiting conditions. In addition continued medical advancements have made more treatment options available to the palliative patient. These may not deliverable in a hospice setting. Few published papers analyse how often and why a patient to is transferred to secondary care from a hospice
Aims This analysis of case notes from a stand-alone hospice in-patient unit examines the conditions when a patient is transferred to hospital.
Methods A retrospective notes review was conducted of patient’s notes who were transferred to hospital over a 3 year period by 2 senior physicians. Patient demographics and reason for transfer were collected.
Result 29 individual patients were transferred during the 3 year period representing 3.2% of all admission during that period. 62% were male, age range was 36–90 with a mean of 63 and the main underlying diagnosis was cancer in 86% In 13 cases a predictable complication of the patient condition necessitated transfer and 15 cases were due to unexpected medical issue, in one case this was at the patient’s request. The specific reasons for transfer are examined in this paper. Time from admission to transfer to hospital was 9 days.
Conclusions This work describes 3 years of experience at our hospice and underlines the need for palliative care staff to be aware of the treatments options available to patients under their care, to be comfortable with uncertain response to treatments, to respect patient wishes and to accept the role secondary care has to play with patients with a palliative diagnosis. This impacts on training and educational needs of the palliative care team.
- Secondary care
- Transfer to hospital
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