Transcript Improving Cancer Care

Improving Cancer
Care
Ramesh Mehay
Gold Standards Framework
The GSF is a
 simple common sensical approach to
formalising best standards of care into
normal practice.
Benefits of GSF
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communication within the team
co-ordination of care
raises the focus of carer support
Unified structured approach to care
The Stages
GSF in Community Pall Care
3 Steps :
+ communication
3. Plan
2. Assess
1. Identify
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Identify this group of patients ie using the
register
Assess for their main needs, both physical
and psychosocial, and that of the carers
Plan ahead for problems, including out of
hours (see model for good practice)
GSF – C1
Practices maintain a Supportive Care register to
record, plan and monitor patient care, and as a
tool to discuss regularly at their monthly PHCT
meetings. The aims of the meetings are to
improve:
 the flow of information
 advanced planning /pro-active care and
 measurement and audit, to clarify areas for
improvement in future
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at patient, practice, PCT and Network level
GSF – C2
Each PHCT has a nominated co-ordinator for palliative care
(e.g District nurse/manager/practice nurse) to ensure good
organisation and co-ordination of care in the practice by
overseeing the process, i.e.
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a) maintaining the register, care plans, symptom sheets
,handover forms, audit data, etc.
b) organising PHCT meetings for discussion, planning,
case analysis, education, etc.
c) using checklists, tools and protocols to cover all areas
of care. eg PACA scale, PEPSI COLA, end-of-life care etc
GSF – C3
Control of Symptoms
GSF – C4
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Continuity of Care (OOH)
GSF – C5
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Continued Learning
GSF – C6
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Carer Support
GSF – C7
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Care of the Dying Phase
Group 1
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Registers :
All cancer patients
Identifying dying patients
DS1500 recording
Group 2
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Communication tools – patient held
records, home packs, drug cards
PHCT meetings
Networking with the wider team
Recording preferred place of death
Avoiding duplication
Group 3
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Control of Symptoms:
EMIS template
Medical, psycho, social, spiritual, religious
Rating scales
Group 4
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OOH
Crisis Contacts
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(Education – of ourselves, audit, books &
resources)
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Carer support
Group 5
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Care of the dying:
A protocol
A PACE like template for each record