In the last 3 months before death, many oncology patients frequently visit the emergency room. Often new or acute symptoms play a role. Sometimes families do not feel well prepared to deal with increasing pain or shortness of breath at home. In many cases, additional care is also needed. These patients require care in a hospice or terminal home care, which currently cannot be organized immediately. This leads to unwanted hospital admissions in the final stage of life. Through this research, we hope to achieve appropriate care in the palliative-terminal phase for oncology patients by establishing an acute hospice bed.
Within this project, we will establish a care pathway: the involved physician at Amsterdam UMC assesses the need for an acute admission to hospice Kuria and consults with the on-call team of hospice Kuria. Upon transfer and admission to hospice Kuria, if there is no expectation of imminent death, plans are made very shortly afterwards based on the wishes of the patient and/or their loved ones for potential palliative terminal care at home or in their own region.

Our aim is that at least 75% of eligible patients for an acute hospice bed will be transferred from Amsterdam UMC to hospice Kuria during this project. An implementation plan and care pathway will be made available for the rest of the region. The realization of an acute hospice bed contributes to more appropriate care in the final stage of life and thus aligns with the improvement of transmural palliative care. In addition, an acute hospice bed can be implemented in more quality mark hospices in the region and can be scaled up to non-oncological conditions. The project is a collaboration between Amsterdam UMC, hospice Kuria, health insurance Zilveren Kruis, and home care provider Cordaan. Other stakeholders (such as GPs) in the Amsterdam-Diemen region are involved through an advisory group. This allows for easy upscaling in case of a successful experiment. The project will start October 1st, 2024.

Project leader: Lia van Zuylen

This article was created for Cancer Center Amsterdam.

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