EU funds help: Hospitals provide better palliative care

The goal of palliative care is to ensure the highest possible quality of life for patients with a life-threatening illness and for their families. This is done through comprehensive support that requires knowledge of the disease and its possible developments, ascertaining the patients' preferences and respecting their wishes. It involves coordination and provision of follow-up services in the final period of life, i. e. alleviating the symptoms of the illness as well as any psychological, social and spiritual difficulties that can trouble the patients and their loved ones.

This medical specialty was supported by an EU-funded project that was implemented between 2017 and 2022. More than CZK 50 million were spent on it, of which European Union funds contributed more than CZK 40 million. "The participating hospitals were the General University Hospital in Prague, the University Hospital Motol, the University Hospital Královské Vinohrady, the University Hospital Olomouc and hospitals in Jihlava and Ústí nad Labem. In the Motol hospital, the project also supported a team specially focused on the care for children," said Vlastimil Válek, Minister of Health.
 
SPECIAL TEAMS ESTABLISHED IN HOSPITALS
The project, aimed at increasing the availability of palliative care services in hospitals as well as the availability of acute and follow-up care, focused on the development of specialized palliative care in the form of palliative consultant teams. This has brought about a service that was available only rarely in Czech hospitals at the beginning of the project.

"The project was created in cooperation of the Ministry of Health with the Czech Society of Palliative Medicine that is part of the Czech Medical Association. As one of the members of the implementation team, I was responsible for the clinical part of introducing palliative teams in the mentioned hospitals. In the implementation group, we prepared a methodology, coordinated its implementation in practice, provided mentoring to the hospitals, and collected data that made it possible to describe the team's activities and its impact on the quality of life of patients, as well as on the care received and the place of stay at the end of life. I am pleased that the palliative team of the General University Hospital in Prague was one of those supported," says Ondřej Kopecký, MD, MHA, head of the Palliative Medicine Clinic at that hospital.

As part of the project, the care was monitored for almost four thousand patients, among them about three hundred children. A standard was established for how the service of hospital palliative teams should function. A consultant palliative care team was introduced in each of the hospitals according to a uniform model. There are four basic professions in the team – doctor with certification in the specialty of palliative medicine, nurse, psychologist, and health-social worker. Many teams also include a chaplain, clinical pharmacist, physiotherapist, and other professions.

"The palliative team visits the patient in any department of the hospital where the patient is currently being treated, while cooperating with the staff of that department," Ondřej Kopecký explains. But the team also has its own facilities, a room where it can meet and hold consultations, for example with family members. Many teams already provide outpatient services.

The largest part of the funds from the project was spent on salaries of the experts mentioned. Until the implementation of the project, there was no reimbursement of these activities in the health care system, and hospitals had to pay for them from their budgets.
 
HEALTH PROFESSIONALS CHANGE THE MINDSET OF THEIR COLLEAGUES
"The project also addressed communication towards colleagues in hospitals to make it clear when and how they can or should call in a palliative team. We go to any department and our partner is not only the patient, but to a large extent also the care staff. We focus on people at an advanced stage of a serious illness who have a lot of needs and need and would welcome someone to help them. Some of our patients have their end of life very short, perhaps a few days, but some live for years," Ondřej Kopecký explains.

The key idea of the project was not to introduce a new device but a new way of thinking for health professionals and patients about life with a serious illness, including the end-of-life situation. "People were treated in the hospital in the same way as before, but in addition to the usual care, they also received the care of the palliative team. The vast majority of patients stated that the disease remained, but their lives improved thanks to palliative support. We are glad that the pilot project is being taken up in other Czech hospitals. Today, palliative teams help patients in already 40 hospitals," the Clinic head Ondřej Kopecký added.
 
“The vast majority of patients stated that the disease remained, but their lives improved thanks to palliative support.” 
Ondřej Kopecký, MD, head of the Clinic
  
EU FUNDS SUPPORTED PALLIATIVE CARE IN HOSPITALS. Six medical facilities in Prague and the regions participated in the palliative care development project. The project established standardized teams that help people with serious illnesses, often at the end of their lives. Ondřej Kopecký, MD, in the picture on the right, the project supervisor, said that the goal was not to introduce any new device, but to change the mindsets of health professionals and patients.

Photo: Deník daily/Jiří Macek + the project archive