Development and evaluation of a protocol about 24/7 availability of specialized palliative care in the home situation.

At the end of life patients are often admitted to the hospital. These hospital admissions can be burdensome and from a medical viewpoint not always necessary. Consequently, patients often die in the hospital although most patients indicate that they want to die at home. To be able to improve the delivery of palliative care at home, a regional protocol about 24/7 availability of specialized palliative care in the home situation is developed. Within this protocol General Practitioners and district nurses who are specialized in palliative care collaborate with the aim to improve timely identification of palliative patients and the delivery of adequate palliative care at home. In complex situations they are advised and coached by members of the specialized palliative care team of the hospital. To evaluate the effect and the process of implementation of this protocol in a large homecare organization in the South-East part of the Netherlands a pre and post evaluation study will be performed.

We expect that patient who receive care according to the protocol about 24/7 availability of specialized palliative care in the home situation, during the year of the study will die more often at home than patients in the years before start of the study.

Measurements of questionnaires are at baseline, 1 month, 2 months and 3 months

Implementation of the protocol about 24/7 availability of specialized palliative care in the home situation.