Wednesday, June 8, 2011

The hope of a better future for the dying

It seems that when a thought just won't go away it's time to write.  If it is a good thought, a necessary thought, then it is time to write and share.  Perhaps even shout.

This is a blog about the quality of end of life care in our hospitals.  It is not an exercise in naming and shaming, but rather a place to explore the concept of the Dying Friendly Hospital inside and out.

In Australia about 150,000 people die each year.  Over half die in public hospitals, usually acute care centers.  An estimated three quarters of these deaths are anticipated i.e. not the result of trauma or accident or unforeseen acute pathology.  So around 60,000 Australians die an anticipated death in a public hospital.
Do they die well?  I am not convinced they always do.

The challenge for the Australian health care system, especially the public health system, is to firstly accept that the majority of Australians will die within hospital walls and thus dying is a core business of our hospital system. Having accepted this there needs to be a commitment to improving the quality of palliative and end of life care in each and every one of our hospitals.  Part of the way ahead will be to recognise that palliative and end of life care has been undervalued in many jurisdictions and that it is an area of investment need of equal importance as all the more politically sensitive and/or popular health care areas.

Our hospitals need to be dying friendly.  This involves best clinical practice (of course) but it also involves policies, processes, values and culture.  I have heard of the dying being seen as bed blockers, or of persons being discharged to residential care facilities only to die within 24 hours. These are not the practices of a dying friendly establishment.

There are many elements to being a Dying Friendly Hospital.  I hope to explore them through this blog.

Finally, a disclaimer.  I have worked in and around the Australian Health Care system for 33 years, and in and around Palliative Care for over 20.  These thoughts and views represent a collective synthesis of that experience, and reflect upon no individual hospital.

Thanks for reading.  My goal is to post weekly.

No comments:

Post a Comment