30 Jul 2020

The relief of patient suffering, supporting complex decision-making, and managing clinical uncertainty are key features of palliative care and essential components of the response to epidemics and pandemics. As we saw pandemics, such as the Covid-19 pandemic, can lead to a surge in demand for health care services, including palliative and end of life care. 

These services must respond rapidly, adopting new ways of working as resources are suddenly stretched. It is important that relevant evidence on the role and response of palliative and hospice care to epi/pandemics is used to inform this response.    

In this study, palliative and end of life care researchers at the ARC conducted a rapid synthesise of evidence on the role and response of palliative care and hospice services to viral epi/pandemics, to inform the Covid-19 pandemic response. 

The research team was led by the ARC’s Professor Katherine Sleeman, and consisted of palliative care physicians, public health physicians and health service researchers with backgrounds in public health, social work and psychology.

Methods

The research team conducted a rapid systematic review across five databases. Of 3094 articles identified, 10 were included in this narrative synthesis. These studies were from West Africa, Taiwan, Hong Kong, Singapore, the U.S., and Italy. All had an observational design. Author findings were synthesized and organised around the following framework:

  • systems – policies, training and protocols, communication and coordination, and data
  • staff – deployment, skill mix, and resilience
  • space – community provision and use of technology
  • stuff – medicines and equipment as well as personal protective equipment.

Conclusions 

Published online in April 2020, the key message from this rapid evidence synthesis was that hospice and palliative care services around the world needed to respond rapidly and flexibly, produce protocols, shift resources to the community, redeploy volunteers, facilitate staff camaraderie, communicate with patients and carers via technology, and standardise data collection. This evidence synthesis has been used to guide hospice and palliative care teams and policymakers in their response to the Covid-19 pandemic.

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