Outcome measures in palliative care: Using the POS family of measures - Two-day workshop (5th and 6th February 2015)
The event attracted 191 people across both days, with some attendees travelling in from countries including Sweden, Italy and Singapore. Attendees included among others; clinicians, researchers and policy makers.
To find out more about this event, please visit the 2015 POS workshop page on the POS website.
Palliative Care Knowledge Exchange Seminar: Wednesday 15th April 2015 (12.30pm - 5.00 pm)
- To consider recent local research and emerging evidence, and evaluate how this might influence clinical practice
- To inform clinicians of research initiatives and collaboratives currently working to communicate, disseminate, embed and maintain approaches to research and best practice
- To discuss the validity of methodology and practices, both holistic and clinical, used to implement research ideas relating to palliative care
Dr Teresa Beynon (Guy’s and St Thomas’ NHS Foundation Trust), Dr Jonathan Koffman (Cicely Saunders Institute), Lisa Brighton (Cicely Saunders Institute), Penny Hansford (St Christopher’s Hospice), Jan Noble (St Christopher’s Hospice), Dr Fliss Murtagh (Cicely Saunders Institute), Dr Gao Wei (Cicely Saunders Institute), Dr Jayne Wood (The Royal Marsden NHS Foundation Trust), Dr Louise Robinson (The Royal Marsden NHS Foundation Trust)
Chaired by: Dr Jonathan Koffman (Senior Lecturer in Palliative Care)
- Health professionals perspectives on Cutaneous T Cell Lymphoma (Dr Teresa Beynon)
- Transforming End of Life Care work – an educational programme for staff (Dr Jonathan Koffman and Lisa Brighton)
- Outcome measurements in OACC and links to the national initiatives (Dr Fliss Murtagh)
- ‘Bromley Care Coordination – the story so far’ (Penny Hansford and Jan Noble)
- Place of death of children and young people with cancer in England (Dr Gao Wei and Joanna Davies)
- A pilot study to evaluate the impact that proactive screening has on Advance Care Planning and referral to Specialist Palliative Care Services within the Lung Oncology Outpatient department (Dr Jayne Wood and Dr Louise Robinson)
Annual Lecture - Clinical interventions to enhance the expectation of healing: continuing on the pathway of Dame Cicely: 6th July 2015
Speaker: Dr Eduardo Bruera, Professor and FT McGraw Chair in the Treatment of Cancer, The University of Texas MD Anderson Cancer Centre
About the speaker:
Dr Bruera is Professor and FT McGraw Chair in the Treatment of Cancer, The University of Texas MD Anderson Cancer Centre. He is Chair, Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Centre, USA and Past President, International Association of Hospice and Palliative Care
A review of clinical research on how the delivery of palliative care can be more effective by making changes in the physical environment (ambient music, no waiting room), measuring symptoms, posture (sitting vs. standing), communication style, physical exam, giving prompt sheets and audio recording and phone care interventions.
Institute Monthly Seminar Series
The Institute hosts a seminar series featuring speakers, presenting on a range of related research topics. The series is free and open to the public. All King’s staff and students are encouraged to attend.
Monday 14th September 2015
Wednesday 22nd July 2015
Advance Care Planning for People with Chronic Kidney Disease
Speaker: Dr Josephine Clayton, Associate Professor of Palliative Care Medicine, University of Sydney/ Consultant Physician in Palliative Medicine
About the speaker:
Josephine is a consultant physician in palliative medicine for Hammond Care’s palliative and supportive care service, based at Greenwich and Royal North Shore Hospitals in Sydney, Australia. She is a busy clinician as well as contributing to research and teaching in her role as associate professor of palliative care, Sydney Medical School, University of Sydney. Josephine leads a research programme regarding communication about end-of-life issues, including the development and evaluation of patient- and clinician-based interventions for improving communication. She has a strong interest in teaching communication skills relevant to the care of patients with life-limiting illnesses.
Recent guidelines have emphasised the importance of providing better support for communication and decision-making about end-of-life issues for people with chronic kidney disease and their families. Advance care planning (ACP) provides a potential solution by promoting discussion between patients, families and healthcare teams regarding values, goals for care, prognosis and end-of-life issues, as well as facilitating documentation of the patient’s wishes for end-of-life care. However, research suggests that ACP may not be widely implemented in renal units. Josephine will present findings from a recent systematic integrative review of the literature on this topic. In addition she will present findings from an Australian national survey of renal clinicians’ views. The aim of this survey was to describe current practice and barriers to ACP from the perspective of renal clinicians in Australia. Implications for clinical practice and future research will be discussed.
Wednesday 24th June 2015
A palliative care approach for people with advanced heart failure: recognition of need, transitions in care, and effect on patients, family, carers and clinicians
Speaker: Dr Amy Gadoud, NIHR Clinical Lecturer in Palliative Medicine, Hull York Medical School
About the speaker:
Amy’s academic post is combined with clinical training as a higher specialty trainee in palliative medicine. Her academic unit is in the Supportive Care, Early Diagnosis and Advanced Disease (SEDA) research group, University of Hull; she also works with colleagues in the Epidemiology, Cancer and Statistics Group, University of York.
Her PhD was awarded in 2014 and explored aspects of a palliative care approach for patients with advanced heart failure. Her post-doctoral work is continuing her interest in palliative care for patients with heart failure and is funded by the NIHR and the Academy of Medical Sciences.
This seminar will outline the main findings from a study exploring a palliative care approach for people with advanced heart failure. The conclusion of the study is that a palliative care approach before the very end of life is beneficial in patients with heart failure. A problem-based flexible approach to recognising the need for palliative care, rather than prognosis, is recommended. The presentation will outline the clinical and policy implications of the study.
Wednesday 27th May 2015
Routine data: costs of care at the end of life
Speaker: Dr Martin Bardsley, Director of Research, Nuffield Trust; and Theo Georghiou, Senior Researcher, Nuffield Trust
About the speakers:
Martin has over 20 years’ experience in health services research and analysis. He leads a team undertaking a research programme that includes studies on the quality of care, development of predictive risk modelling and the evaluation of alternative models for delivering health services. He previously worked as Head of Screening & Surveillance at the Healthcare Commission and in public health. He has a PhD from the London School of Economics and is a Fellow of the Faculty of Public Health.
Theo’s interests include predictive risk techniques, methodologies for the evaluation of complex interventions and end-of-life care. In his previous role at the King’s Fund he was part of the team that developed the Patients at Risk of Readmissions tool. At the Nuffield Trust he makes use of a wide range of data sources, including those from social care and GP systems. He is now involved in evaluating the role of volunteers in helping to avoid unplanned hospital admissions, and is documenting variations in the use of hospital care at the end of life. Theo has a master’s degree in Experimental and Theoretical Physics from the University of Cambridge.
Wednesday 29th April 2015
Diagnoses, problems and healthcare interventions amongst frail older people admitted to hospital as an emergency
Speaker: Professor Rowan Harwood, Consultant Physician and Professor of Geriatric Medicine, Nottingham University Hospitals NHS Trust
About the speaker:
Rowan is a consultant geriatrician with an active role in research and teaching. His wide clinical and research interests include delirium, dementia, stroke, continence, rehabilitation, end-of-life care, falls and clinical ethics. In 2009, following 10 years in stroke medicine, he embarked on a programme to develop and evaluate better ways to manage cognitively-impaired older people in general hospitals and other dementia-related research.
The predominant users of acute medical services are frail older people. It was found that 1 in 3 people who had emergency hospital admissions had delirium or dementia; they also had multiple co-morbidities and a high prevalence of physical disability and psychopathology. A specialist medical and mental health unit to care for these patients more appropriately was evaluated in a randomised controlled trial. Hard measures of health status and resource use were marginally better for patients on the specialist wards, but measures of patient experience and family carer satisfaction were substantially improved.
Wednesday 22nd April 2015
Better informing decision-making with multiple outcomes cost-effectiveness analysis in palliative care
Speaker: Dr Nikki McCaffrey, Health Economist, Flinders Health Economics Group, Flinders University, Australia and the Australian Palliative Care Clinical Studies Collaborative (PaCCSC)
About the speaker:
Nikki is a health economist with Flinders Health Economics Group, Flinders University, South Australia and the Australian Palliative Care Clinical Studies Collaborative (PaCCSC), a national collaboration of researchers engaged in Phase III studies in palliative care. She is an investigator on competitive research grants totalling more than AU$4.3 million. Her original research includes: comparison in cost-disutility space when comparing more than two strategies with multiple outcomes in health technology assessment; outcome measurement in palliative care economic evaluations, including the development of disease specific preference based economic measures; evaluation of community models of palliative care; and development of discrete choice attributes from qualitative data.
Health and social costs globally are escalating. Funders, clinicians and policy makers need to make difficult decisions about where best to invest limited public funds. Economic evaluations systematically compare the costs and benefits of different strategies and help inform decision-makers about how best to maximise benefits for patients from public spending. However, capturing and comparing a range of benefits is important, yet challenging in areas like palliative care.
In this seminar, Nikki will highlight the limitations of traditional approaches to multiple outcomes cost-effectiveness analysis in palliative care and present a new approach, multiple outcomes cost-effectiveness analysis under uncertainty in cost-disutility space. She will illustrate the new method with two palliative care case studies and discuss the relative merits of the new approach for informing funders, clinicians and policy makers.
Wednesday 25th March 2015
Managing uncertainty for people with dementia in care homes
Speaker: Professor Claire Goodman; Professor of Health Care Research, Centre for Research in Primary and Community Care, University of Hertfordshire
About the speaker:
Claire has a background in district nursing. Her research focuses on the oldest old and how primary health care can work with social care and third-sector providers to support this population. This includes nationally funded studies on end-of-life care for older people with dementia, inter-professional working for older people with complex needs living at home, and interventions that support effective working between primary health care services and care homes. She is a Deputy Director of the East of England CLAHRC and she was a member of the EU JPND EU Palliative and End of Life Care Research in Neurodegenerative Diseases Action Group. She recently published an editorial in Palliative Medicine with Jenny van der Steen, ‘What research we no longer need in neurodegenerative disease at the end of life: the case of research in dementia’.
The withdrawal of the Liverpool Care Pathway (LCP) goes to the heart of assumptions about how dying is recognised, what is known about how people die, who provides the care and who makes the decisions regarding treatment options. There is recognition that even the term ‘pathway’ is misleading. This presentation will draw on findings from three recently completed care home studies on end-of-life care that included people with dementia. It will consider if an intervention’s ability to ‘hold’ uncertainty between the different players and organisations at different points in the dementia trajectory is as important as the use of structured approaches to assessment and communication, training, facilitation of learning and access to expertise in palliative care.
Wednesday 25th February 2015
Speaker: Professor Jo Rycroft-Malone; Professor of Health Services and Implementation Research, Head of School for Healthcare Sciences and Academic Lead for Impact, Bangor University
About the speaker:
Jo co-leads an internationally recognised implementation research programme at Bangor University and works at the interface of research and practice. She is an editor of the International Journal of Health Policy and Management and an editorial board member of BMC Implementation Science; previously, she was the inaugural editor of Worldviews on Evidence-Based Nursing and associate editor of BMC Trials.
Jo has been an adviser and member of a number of international and national strategy development ‘think tanks’ and funding groups. In 2012, she was appointed Chair of the National Institute for Health and Care Excellence (NICE) Implementation Strategy Group. She has been involved with the National Institute for Health Research (NIHR) for a number of years and will take over the role of Director for the NIHR Health Services and Delivery Research programme in autumn 2015.
The seminar will cover what constitutes implementation science and what doesn’t, as well as unpacking some of the core concepts and theory. This will also be an opportunity to share some evidence-based insights into conducting implementation research.
Has hospice passed its “sell by date”?
Speaker: Professor Barbara Monroe
About the speaker:
Barbara was a social worker for over 40 years. She joined St Christopher’s Hospice in 1987, became Chief Executive in 2000 and retired in August 20014. She founded and was the Director of the Candle children’s bereavement project at St Christopher’s and chaired the national Childhood Bereavement Network for eight years. Barbara is a well-known speaker and lecturer and has delivered training programmes across the world. She has written extensively about psychological and social aspects of palliative care and sits on a variety of national committees supporting the development of end of life care. Barbara is an Honorary Professor at the International Observatory on End of Life Care at Lancaster University and has a long term interest in how we achieve ‘good enough’ end of life care for all. She was appointed Dame Commander of the Order of the British Empire in the Queen’s Birthday Honours List 2010. She was Vice Chairman of the Commission on the Future of Hospice Care which reported in October 2013. She holds a number of voluntary roles including Special Commissioner of the Royal Hospital Chelsea and Trustee of Marie Curie.
This talk will explore the core values and legacy of the hospice concept established by Dame Cicely Saunders in founding St Christopher’s in 1967. It will examine the evidence for hospice efficacy in meeting current need and look at the role hospices might play in managing future challenges in the provision of end of life care.