title: Help is just a phone call away: after-hours support for palliative care patients wishing to die at home.
abstract: The 24-hour support for palliative patients is the gold standard of health care in Australia. However, in the state of Tasmania after-hours telephone support was spatially fragmented and inequitable. In 2014, hospice@HOME, a pilot programme introduced in Tasmania in that year, implemented a state-wide after-hours palliative care support service--1800HOSPICE--offering 24-hour support, 7 days a week for palliative patients, caregivers and the public. Six months of after-hours call logs in combination with additional patient data, were analysed to evaluate the use and wider implications of a state-wide after-hours palliative care support number. Family and caregivers mainly used the after-hours support to request changes to support services (25.1%), report changes in patients' overall condition (23.6%) and request acute medical assistance (16.2%). Through the use of the after-hours services by all individuals involved in the care, end-of-life patients were able to reduce ambulance contact and emergency department admission, and thereby increase their likelihood of dying at home (for patients whose preference was to die at home). Overall, 24-hour palliative care telephone support was found to be a valuable tool for all individuals involved in the care of end-of-life patients.
authors.affiliation: PhD student at the University of Tasmania, Australia.
authors.forename: Debbie
authors.initials: D
authors.lastname: Baird-Bower
authors.affiliation: Research Coordinator at The District Nurses hospice@HOME, Moonah, Tasmania, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Roach
authors.affiliation: Research Co-ordinator at The District Nurses hospice@HOME, Moonah, Tasmania, Australia.
authors.forename: Morven
authors.initials: M
authors.lastname: Andrews
authors.affiliation: Director of State Operations at The District Nurses hospice@HOME, Moonah, Tasmania, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Onslow
authors.affiliation: Clinical Project Manager at The District Nurses hospice@HOME, Moonah, Tasmania, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Curnin
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration*; D015277:Hotlines; D006801:Humans; D010166:Palliative Care / Q000458:organization & administration*; D010343:Patient Admission / Q000706:statistics & numerical data; D010865:Pilot Projects; D013648:Tasmania
keywords: Ambulance service; Avoidable hospital admissions; End-of-life; Telephone support