title: A new palliative care consultation team at the oncology department of a university hospital: an assessment of initial efficiency and effectiveness.
abstract: OBJECTIVE
  Palliative care consultation teams (PCCT) in acute hospitals have increased in number over recent years. To assess whether these teams are both efficient in their role within a palliative care centre and effective in the care that is provided for patients, we reviewed the initial activity of a new PCCT at the Oncology Department of Clínica Universidad de Navarra, a European Society for Medical Oncology-designated centre of integrated oncology and palliative care.
  
  
  METHODS
  All patients evaluated by the PCCT over the first 3 years of its activity were included. Data about diagnosis, demographic characteristics, survival and initial symptom burden were evaluated using the Edmonton Symptom Assessment System (ESAS); whenever possible, a follow-up ESAS for inpatients was collected within 1 week from the electronic charts and analysed retrospectively.
  
  
  RESULTS
  The PCCT evaluated 611 cancer patients within the initial 3 years of the service commencing. On the first visit, 392 patients (64%) completed the ESAS evaluation. Of those that completed the ESAS, 43% were outpatients, 52% had gastrointestinal tumours, and 16% died within a month. The evaluated patients had an average of six uncontrolled symptoms (≥4/10). The most common moderate to severe symptoms were fatigue (80%), anorexia (67%) and depression (62%); 70% of patients presented with pain (14% with severe pain). Of the 225 inpatients evaluated, 110 (49%) completed the follow-up ESAS within 1 week. A statistically significant decrease was observed for pain, nausea, depression, anxiety and somnolence as well as in the number of uncontrolled symptoms and in the symptom distress score. The patient's perception of his/her general well-being was better as meassured with the specific question of ESAS.
  
  
  CONCLUSIONS
  From the initial stages, the PCCT was both efficient in its role within the palliative care centre and effective in the care that was provided for patients. A significant number of patients were evaluated, many of them with severe symptoms and/or at the end of life. Inpatients receiving care from the PCCT experienced an improvement in symptom control within just a few days.
authors.affiliation: Department of Palliative Care, Hospital Centro de Cuidados Laguna, Madrid, Spain. anadsantiago@yahoo.es
authors.forename: Ana
authors.initials: A
authors.lastname: de Santiago
authors.forename: María Angustias
authors.initials: MA
authors.lastname: Portela
authors.forename: Luis
authors.initials: L
authors.lastname: Ramos
authors.forename: Ana
authors.initials: A
authors.lastname: Larumbe
authors.forename: Julia
authors.initials: J
authors.lastname: Urdiroz
authors.forename: Marina
authors.initials: M
authors.lastname: Martínez
authors.forename: Jesús
authors.initials: J
authors.lastname: García-Foncillas
authors.forename: Carlos
authors.initials: C
authors.lastname: Centeno
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008485:Medical Audit; D016522:Oncology Service, Hospital; D009936:Organizational Innovation; D010166:Palliative Care; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D012189:Retrospective Studies; D013030:Spain