Requests from professional care providers for consultation with palliative care consultation teams.
OBJECTIVE
Professional care providers need a substantial basis of competence and expertise to provide appropriate palliative care. Little is known about the problems professionals experience in their palliative care provision in daily practice or about the nature of the advice and support they request from experts. Our aim was to investigate the extent to which professionals requested assistance from palliative care consultation teams and the reasons behind these requests to trace any gaps they experience in the provision of palliative care.


METHODS
As part of a large national palliative care development programme, we studied requests for consultation made by professional care providers over a 2-year period. The requests for consultation were recorded on a specially developed standard registration form and classified according to 11 domains relevant to palliative care.


RESULTS
Professional care providers requested 4351 consultations on account of 8413 specific problems in 11 quality-of-life and quality-of-care domains. The distribution of problems over these domains was unbalanced: 42.2% of the specific problems were physical, while the percentages of psychological, pharmacological and organizational problems were 7.7, 12.5 and 12.8%, respectively. In contrast, issues of a spiritual nature or concerned with daily functioning were raised infrequently (1.1 and 0.9%). Details of the specific problems in all the domains are described in the text and tables.


CONCLUSIONS
The results of our study form a valid basis on which to develop and implement improvements in palliative care. We recommend that future well-founded policies for palliative care should incorporate palliative care consultation as well as educational and organizational interventions.
Groot
Marieke M
MM
Centre for Quality of Care Research (229), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. c.groot@kwazo.umcn.nl
Vernooij-Dassen
Myrra J F J
MJ
Courtens
Annemie M
AM
Kuin
Annemieke
A
van der Linden
Barbara A
BA
van Zuylen
Lia
L
Crul
Ben J P
BJ
Grol
Richard P T M
RP
D002983:Clinical Competence; D003299:Cooperative Behavior; D006761:Hospitals; D006801:Humans; D009426:Netherlands; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D016730:Program Development; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000592:standards*