4th Nursing World Conference
- August 19-21, 2019
- London, UK
Dr. Gebhard Mathis studied at the Medical Universitiy of Medicine in Vienna. He received the MD there at 2079. He worked on palliative medicine since in different fields: Foundation of Palliative Courses in Austria since 1999, the Palliative Care sSation in LKH Hohenems 2003, more than 100 Publications.
Background: In crisis situations, comprehensive palliative care in care homes is frequently hindered by the absence of a doctor.
Aim: To improve advanced care planning in care homes by the establishment of medical coordination.
Methods: Medical coordination facilities were established in three care homes housing a total of 266 residents. The effect was compared with three care homes without medical coordination. Formative evaluation: In two focus groups, at the start and around the end of the twelve-month period the involved persons in the test and reference care homes as well as practicing doctors and health experts exchanged their views on the subject. 16 experts provided detailed information about specific aspects of the model project in the course of qualitative interviews. Furthermore, in a summative evaluation the following aspects were investigated: emergency plans, the registration of presumed will, emergency doctors' missions, the number of ambulance services, and the provision of emergency medication. Statistics: Mann-Whitney U-test, Box-Ljung.
Results: Representatives of the test care homes reported their positive views concerning the model project: the expansion of consciousness and the introduction of structures for palliative work in homes for the aged, optimized coordination between nurses and doctors, the systematic documentation of helpful emergency plans, stores of on-demand medication in care homes, uninterrupted care, improvement of quality, and reduction of costs. The time curves for the five care-home-related parameters revealed significantly positive changes compared to reference care homes: 74%:48% and 61%:39%.
Conclusion: Medical coordination in the care home improves the quality of care for the residents. The economic evaluation shows that undignified ambulance services and unnecessary emergency doctors' missions can be considerably reduced by medical coordination.