Journal of Pain and Symptom Management
Volume 38, Issue 4 , Pages 496-504 , October 2009

Development of a Standard for Hospital-Based Palliative Care Consultation Teams Using a Modified Delphi Method

  • Tomoyo Sasahara, RN, PhD

      Affiliations

    • Institute of Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
    • Corresponding Author InformationAddress correspondence to: Tomoyo Sasahara, RN, PhD, Institute of Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Ten-nodai, Tsukuba, Ibaraki 305-8575, Japan.
    • ,
  • Yoshiyuki Kizawa, MD

      Affiliations

    • Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
    • ,
  • Tatsuya Morita, MD

      Affiliations

    • Department of Palliative and Supportive Care, Palliative Care Team and Seirei Hospice, Seirei Mikatahara General Hospital, Shizuoka, Japan
    • ,
  • Yuumi Iwamitsu, PhD

      Affiliations

    • Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
    • ,
  • Junji Otaki, MD, DMedSc

      Affiliations

    • Department of General Medicine and Primary Care, Tokyo Medical University Hospital, Tokyo, Japan
    • ,
  • Hitoshi Okamura, MD, PhD

      Affiliations

    • Psychosocial Rehabilitation Laboratory, Graduate School of Health Sciences, Hiroshima University, Hiroshima, Japan
    • ,
  • Mikako Takahashi, RN, MS

      Affiliations

    • Palliative Care Unit, St. Luke's International Hospital, Tokyo, Japan
    • ,
  • Sayaka Takenouchi, RN, MPH

      Affiliations

    • Department of Biomedical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
    • ,
  • Seiji Bito, MD

      Affiliations

    • Division of Clinical Epidemiology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan

,Accepted 19 February 2009.

References 

  1. Emanuel EJ, Emanuel LL. The promise of a good death. Lancet. 1998;351:21–29
  2. Singer PA, Martin DK, Kelner M. Quality end-of-life care: patients' perspectives. JAMA. 1999;281:163–168
  3. Morrison RS, Maroney-Galin C, Kralovec PD, Meier DE. The growth of palliative care programs in United States hospitals. J Palliat Med. 2005;8:1127–1134
  4. The National Council for Palliative Care. MDS full report for the year 2006–2007. Available from http://www.ncpc.org.uk/download/mds/MDS_Full_Report_0607part.pdf. Accessed July 10, 2008.
  5. Palliative Care Australia. State of the nation 1998, report of national census of palliative care services. Available from http://www.palliativecare.org.au/Portals/46/reports/Census98.pdf. Accessed July 10, 2008.
  6. Kuin A, Courtens AM, Deliens L, et al. Palliative care consultation in The Netherlands: a nationwide evaluation study. J Pain Symptom Manage 2004;27:53–60.
  7. Ministry of Health, Labour and Welfare. Vital statistics of population 2003. [Japanese]. Available from http://wwwdbtk.mhlw.go.jp/toukei/data/010/2003/toukeihyou/0004649/t0095927/JC050000_001.html. Accessed July 10, 2008.
  8. Okuyama T, Wang XS, Akechi T, et al. Adequacy of cancer pain management in a Japanese cancer hospital. Jpn J Clin Oncol. 2004;34:37–42
  9. Morita T, Akechi T, Ikenaga M, et al. Late referrals to specialized palliative care service in Japan. J Clin Oncol. 2005;23:2637–2644
  10. Morita T, Akechi T, Ikenaga M, et al. Communication about the ending of anticancer treatment and transition to palliative care. Ann Oncol. 2004;15:1551–1557
  11. Ministry of Health, Labour and Welfare. The list of regional cancer centers. [Japanese]. Available from http://www.mhlw.go.jp/bunya/kenkou/gan04/index.html. Accessed July 10, 2008.
  12. Ministry of Health, Labour and Welfare. The guideline for developing regional cancer centers. [Japanese]. Available from http://www.mhlw.go.jp/topics/2006/02/tp0201-2.html. Accessed June 10, 2008.
  13. Hospice Palliative Care Japan. Standard for hospice palliative care. [Japanese]. Available from http://www.hpcj.org/what/gd_kijyun.html. Accessed November 25, 2008.
  14. Department of Health. Manual for cancer services 2004. Available from http://www.dh.gov.uk/en/Healthcare/NationalServiceFrameworks/Cancer/DH_4135595. Accessed July 10, 2008.
  15. Palliative Care Australia. Standards for providing quality palliative care for all Australians. Available from http://www.palliativecare.org.au/portals/46/resources/StandardsBrochure.pdf. Accessed July 10, 2008.
  16. National Consensus Project. Clinical practice guidelines for quality palliative care. Available from http://www.nationalconsensusproject.org/Guideline.pdf. Accessed November 25, 2008.
  17. Clinical Standards Board for Scotland . Clinical standards specialist palliative care. Edinburgh, UK: Clinical Standards Board for Scotland; 2002;
  18. Salisbury C. Models of palliative care. In:  Bosanquet N,  Salisbury C editor. Providing a palliative care service. Oxford, UK: Oxford University Press; 1999;p. 57–68
  19. Carter H, McKinlay E, Scott I, Wise D, MacLeod R. Impact of a hospital palliative care service: perspective of the hospital staff. J Palliat Care. 2002;18:160–167
  20. Sasahara T, Umeda M, Higuchi H, et al. What kind of support does hospital-based palliative care team provide in a university hospital?: a result from participant-observation approach. [Japanese] J Jpn Soc Cancer Nurs. 2008;22:12–22
  21. Fitch K, Bernstein SJ, Aguilar MD, et al. The Rand/UCLA appropriateness method user's manual. Santa Monica, CA: RAND; 2001;
  22. Center to Advance Palliative Care. Crosswalk of JCAHO standards and palliative care-policies, procedures and assessment tools. March 2007. Available from http://www.capc.org/support-from-capc/capc_publications/JCAHO-crosswalk-new.pdf. Accessed July 10, 2008.
  23. Hunt J, Keeley VL, Cobb M, Ahmedzai SH. A new quality assurance package for hospital palliative care teams: the Trent Hospice Audit Group model. Br J Cancer. 2004;91:248–253
  24. Manfredi PL, Morrison RS, Morris J, et al. Palliative care consultations: how do they impact the care of hospitalized patients?. J Pain Symptom Manage. 2000;20:166–173
  25. Zhukovsky DS. A model of palliative care: the palliative medicine program of the Cleveland Clinic Foundation. A WHO demonstrations project. Support Care Cancer. 2000;8:268–277
  26. O'Mahony S, Blank AE, Zallman L, Selwyn PA. The benefits of a hospital-based inpatient palliative care consultation service: preliminary outcome data. J Palliat Med. 2005;8:1033–1039
  27. Morita T, Fujimoto K, Tei Y. Palliative care team: the first year audit in Japan. J Pain Symptom Manage. 2005;29:458–465
  28. Homsi J, Walsh D, Nelson KA, et al. The impact of a palliative medicine consultation service in medical oncology. Support Care Cancer. 2002;10:337–342
  29. Vernooij-Dassen MJ, Groot MM, van den Berg J, et al. Consultation in palliative care: the relevance of clarification of problems. Eur J Cancer. 2007;43:316–322
  30. Keeney S, Hasson F, McKenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research. J Adv Nurs. 2006;53:205–212
  31. Fischberg D, Meier DE. Palliative care in hospitals. Clin Geriatr Med. 2004;20:735–751
  32. Hanks GW, Robbins M, Sharp D, et al. The imPaCT study: a randomised controlled trial to evaluate a hospital palliative care team. Br J Cancer. 2002;87:733–739
  33. Higginson IJ, Finlay I, Goodwin DM, et al. Do hospital-based palliative teams improve care for patients or families at the end of life?. J Pain Symptom Manage. 2002;23:96–106
  34. Groot MM, Vernooij-Dassen MJ, Courtens AM, et al. Requests from professional care providers for consultation with palliative care consultation teams. Support Care Cancer. 2005;13:920–928
  35. Morita T, Fujimoto K, Imura C, et al. Self-reported practice, confidence, and knowledge about palliative care of nurses in a Japanese regional cancer center: longitudinal study after 1-year activity of palliative care team. Am J Hosp Palliat Care. 2006;23:385–391
  36. Virik K, Glare P. Profile and evaluation of a palliative medicine consultation service within a tertiary teaching hospital in Sydney, Australia. J Pain Symptom Manage. 2002;23:17–25
  37. Miyashita M, Sasahara T. Clinical audit for palliative care team. [Japanese] Jpn J Palliat Med. 2006;8(2):111–118
  38. Akechi T. The role of a psychiatrist in a palliative care team. [Japanese] Clinical Psychiatry. 2007;49:907–913
  39. Gwyther LP, Altilio T, Blacker S, et al. Social work competencies in palliative and end-of-life care. J Soc Work End Life Palliat Care. 2005;1(1):87–120
  40. Omatsu S, Yokokawa M, Ideshita N. Palliative care team and the medical linkage. [Japanese] Symptom Management in Cancer Patients. 2004;15(2):34–38
  41. Gilbar P, Stefaniuk K. The role of the pharmacist in palliative care: results of a survey conducted in Australia and Canada. J Palliat Care. 2002;18:287–292
  42. Kuratsuji Y, Shiokawa M. A role of pharmacologist in palliative care team. [Japanese] J Jpn Soc Hosp Pharm. 2006;42:1027–1030
  43. Kanbayashi Y, Konishi Y, Nishii H. The roles of pharmacist in the pain treatment and palliative care unit. [Japanese] Journal of Kyoto Prefectural University of Medicine. 2006;115:201–209
  44. Payne S, Haines R. The contribution of psychologists to specialist palliative care. Int J Palliat Nurs. 2002;8:401–406
  45. Kurihara Y. The role of clinical psychologist. [Japanese] Jpn J Clin Nurs. 2005;31:1057–1061
  46. Santiago-Palma J, Payne R. Palliative care and rehabilitation. Cancer. 2001;92(4 Suppl):1049–1052
  47. Imai S, Suzuki A, Murata J, Taguchi N. The activity of palliative care support team and physical therapist. [Japanese] Kokuritsudaigakuhojin Rehabilitation co-medical Gakujutsu-taikaishi. 2007;28:72–75
  48. Masuda Y, Tajiri H, Tsuji T. The role of physical therapist and occupational therapist. [Japanese] Sogo Rehabil. 2003;31:953–959
  49. Noguchi W, Matsushima E. The role of psychiatrist as a “coordinator” and “breakwater” in palliative care team. [Japanese] Clinical Psychiatry. 2007;49:915–919
  50. Akizuki N. From the viewpoint of a psychiatrist: analysis of the questionnaire to the participants for the palliative care team workshop. [Japanese] Clinical Psychiatry. 2007;49:901–905
  51. Salerno SM, Hurst FP, Halvorson S, Mercado DL. Principles of effective consultation: an update for the 21st-century consultant. Arch Intern Med. 2007;167:271–275
  52. Smith KL, Soriano TA, Boal J. Brief communication: national quality-of-care standards in home-based primary care. Ann Intern Med. 2007;146:188–192
  53. Miyashita M, Nakamura A, Morita T, Bito S. Identification of quality indicators of end-of-life cancer care from medical chart review using a modified Delphi method in Japan. Am J Hosp Palliat Care. 2008;25:33–38
  54. Oakley C, Pennington K, Mulford P. Perceptions of the role of the hospital palliative care team. Nurs Times. 2005;101:38–42
  55. Mytton EJ, Adams A. Do clinical nurse specialists in palliative care de-skill or empower general ward nurses?. Int J Palliat Nurs. 2003;9:64–72
  56. Miyashita M, Nishida S, Koyama Y, et al. The current status of palliative care teams in Japanese university hospitals: a nationwide questionnaire survey. Support Care Cancer. 2007;15:801–806

 This work was supported by a Health and Labour Sciences Research Grant for Clinical Cancer Research.

PII: S0885-3924(09)00703-9

doi: 10.1016/j.jpainsymman.2009.01.007

Journal of Pain and Symptom Management
Volume 38, Issue 4 , Pages 496-504 , October 2009

Article Tools