Authors (including presenting author) :
Chan CO(1), Lam KY(1)
Affiliation :
(1) Department of Rehabilitation and Extended Care, TWGHs Wong Tai Sin Hospital
Introduction :
Palliative Care (PC) is essential in improving quality of life of patients and their families in facing life-limiting illnesses. Before 2020, there were no specialist-led PC service in Kwong Wah Hospital (KWH) and Kowloon Hospital (KH) of Kowloon Central Cluster (KCC). A cluster-based multi-disciplinary team consisting PC physicians, PC nurses and medical social workers (MSW) was launched in September 2020.
Objectives :
(1)To provide PC specialist in-patient consultation in KWH and KH; (2)To provide PC specialist out-patient clinic (SOPC) in KWH and TWGHs Wong Tai Sin Hospital; (3)To enhance PC home care service in KCC.
Methodology :
Service deliverables, patient characteristics and interventions delivered in the first two years of program (from 21 September 2020 to 30 September 2022) were captured and analyzed, with major findings reported.
Result & Outcome :
For in-patient consultation, 948 new patients were reached, with a total of 2482 visits. The mean waiting time was 0.47 working days(median 0). The median duration of first visit until discharge, transfer or death was only 3 days. The mean age of patients was 76(Range 18-108). Majority of patients had cancer(82%) or end-stage renal failure(13%). Pain(45%), sleep disturbance(36%), anorexia(31%), fatigue(28%) and dyspnea(26%) were prevalent physical symptoms, while caregiver stress(31%) and bereavement risk(26%) were prevalent psychosocial issues. Introduction of PC service(90%), psychological support(98%) and discussion on advance care planning(74%) were mostly delivered. The commonest treatment suggestions were analgesic titration(50%) and drug simplification(41%). Care coordination was universally provided. 24% of patients deceased within the same admission, while 31% were transferred to PC units. PC SOPC was offered to discharged patients as appropriate. For SOPC, 272 new patients were seen, with a median waiting time of 3 weeks. For Home care service, 234 patients with 1272 visits were made. Bereavement support was provided by MSW to selected patient-cases who were ever seen by us, but deceased afterwards in non-PC settings. In conclusion, our program provided timely and valuable PC service coverage to patients and families in need.
