Howell Doris, Prestwich Catherine, Laughlin Emmy, Giga Nasreen
University Health Network, Toronto, Ontario, Canada.
Lippincotts Case Manag. 2004 Jul-Aug;9(4):166-74; quiz 175-6. doi: 10.1097/00129234-200407000-00003.
Palliative home care is an important component of the care system for patients at the end of life and case management is considered an essential element of the Canadian home care system. Case managers play a critical role in allocating resources, thus influencing the costs and the viability of palliative home care. Case management education programs focused on care coordination with specialty palliative care populations are nonexistent. An education program targeted at improving the knowledge and skills of case managers in allocating resources to palliative care populations was developed and pilot-tested in a metropolitan Canadian city home care program. Core curriculum was based on an initial learning needs assessment and used case-based problem solving to enhance case-management skills. An improvement in knowledge was noted on posttests and case managers described increased comfort and confidence in their role as case managers to this patient population. Home care organizations caring for palliative care populations must ensure case managers are prepared for case management roles with specialty populations if the home is to be rendered an appropriate and viable care setting for patients at the end of life.
姑息性家庭护理是临终患者护理系统的重要组成部分，而病例管理被认为是加拿大家庭护理系统的一个基本要素。病例管理者在资源分配中发挥着关键作用，从而影响姑息性家庭护理的成本和可行性。目前不存在专注于与专科姑息治疗人群进行护理协调的病例管理教育项目。在加拿大一个大城市的家庭护理项目中，开发并试点测试了一个旨在提高病例管理者向姑息治疗人群分配资源的知识和技能的教育项目。核心课程基于初步的学习需求评估，并采用基于案例的问题解决方法来提高病例管理技能。后测结果显示知识有所提高，病例管理者表示在作为针对该患者群体的病例管理者角色中，他们的舒适度和信心有所增强。如果要使家庭成为适合临终患者的适当且可行的护理场所，照顾姑息治疗人群的家庭护理组织必须确保病例管理者为针对专科人群的病例管理角色做好准备。
