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Multidisciplinary Approach and Coordination of Care

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Essentials of Palliative Care

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Abstract

Palliative care aims to reduce distress, enhance functioning, and improve the quality of life of people and their families facing life-threatening diseases, rather than directly aiming at cure or disease modification. Palliative care addresses the multiple domains of needs and concerns of the patient and the family—physical, psychological, social, and spiritual. These needs cannot be addressed by one single person or agency without causing fragmentation of care. Hence a multidisciplinary approach is the backbone of palliative care. In this approach, inputs are obtained and integrated from multiple sources depending upon, among other factors, stage of disease progression, pain and other symptoms, patient’s and family’s psychological state, social and practical requirements, and available resources. Doctors, nursing staff, social worker, and many others involved in the multifaceted care of the patient form the multidisciplinary team, which provides this care in a coordinated manner so as to provide continuity of care. There are many advantages of the multidisciplinary approach, and its efficacy has been demonstrated convincingly in increasing satisfaction of the patient and family, improving quality of life, and even a modest increase in survival for some patients. However, the multidisciplinary approach has its own barriers and challenges. Some of these can be at least partly overcome with an effective coordination of care between different locations, personnel, and time points of care.

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Author information

Authors and Affiliations

  1. Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India

    Sukanya Mitra M.D.

  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, USA

    Nalini Vadivelu M.D.

Authors
  1. Sukanya Mitra M.D.
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  2. Nalini Vadivelu M.D.
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Corresponding author

Correspondence to Sukanya Mitra M.D. .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Yale University, New Haven, 06520, Connecticut, USA

    Nalini Vadivelu

  2. Citrus Road 278, River Ridge, 70123, Louisiana, USA

    Alan David Kaye

  3. Keck School of Medicine, Department of Anesthesiology, Pain Medic, of the University of Southern California, Los Angeles, 90035, California, USA

    Jack M. Berger

Appendices

Review Questions

  1. 1.

    According to the World Health Organization definition of palliative care, the essential aim of palliative care is to:

    1. (a)

      Correct the underlying metabolic derangements in life-threatening disease

    2. (b)

      Focus on disease modification

    3. (c)

      Improve the quality of life

    4. (d)

      Provide symptomatic and psychosocial support exclusively for the patient

  2. 2.

    Palliative care is:

    1. (a)

      Disease centered

    2. (b)

      Patient centered

    3. (c)

      Family centered

    4. (d)

      Patient- and family centered

  3. 3.

    The needs addressed by palliative care does not include:

    1. (a)

      Spiritual

    2. (b)

      Curative

    3. (c)

      Psychosocial

    4. (d)

      Physical

  4. 4.

    The number of domains of palliative care endorsed by both National Consensus Project (NCP) and National Quality Forum (NQF) is:

    1. (a)

      4

    2. (b)

      6

    3. (c)

      8

    4. (d)

      10

  5. 5.

    According to NCP Clinical Practice Guidelines 2009, the core group in an interdisciplinary (multidisciplinary) palliative care team should have professionals from all the following disciplines except:

    1. (a)

      Psychology

    2. (b)

      Social work

    3. (c)

      Nursing

    4. (d)

      Medicine

  6. 6.

    According to expanded model and scope of palliative care, such care can start at the level of :

    1. (a)

      Primary care

    2. (b)

      Secondary care

    3. (c)

      Tertiary care

    4. (d)

      Any of the above levels

  7.  7.

    The following statement is true regarding research-evidenced benefits of a multidisciplinary team (MDT) in palliative care:

    1. (a)

      Modest increase in survival of certain cancer patients

    2. (b

      No effect on patient satisfaction

    3. (c)

      No effect on quality of life

    4. (d)

      Time delay in reaching consensus opinions

  8.  8.

    Coordination of care is important for:

    1. (a)

      The patient

    2. (b)

      The MDT

    3. (c)

      The healthcare system

    4. (d)

      All of the above

  9.  9.

    For patients in palliative care, the overall aim of coordination of care is to provide:

    1. (a)

      Consultations from various doctors

    2. (b)

      Arrangement of MDT meetings

    3. (c)

      Continuity of care over time and across settings

    4. (d)

      Bereavement counseling

  10. 10.

    The Advanced Certification Program for Palliative Care announced by the Joint Commission is designed for the following type of palliative care program (as of September 2011):

    1. (a)

      Outpatient based

    2. (b)

      Inpatient based

    3. (c)

      Community based

    4. (d)

      Hospice based

Answers

  1. 1.

    (c)

  2. 2.

    (d)

  3. 3.

    (b)

  4. 4.

    (c)

  5. 5.

    (a)

  6. 6.

    (d)

  7. 7.

    (a)

  8. 8.

    (d)

  9. 9.

    (c)

  10. 10.

    (b)

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Mitra, S., Vadivelu, N. (2013). Multidisciplinary Approach and Coordination of Care. In: Vadivelu, N., Kaye, A., Berger, J. (eds) Essentials of Palliative Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5164-8_2

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  • DOI: https://doi.org/10.1007/978-1-4614-5164-8_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-5163-1

  • Online ISBN: 978-1-4614-5164-8

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