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Home / Health / Martha L. Twaddle, MD: Updated National Clinical Guidelines for Palliative Care

Martha L. Twaddle, MD: Updated National Clinical Guidelines for Palliative Care



As critically ill patients and their families are the largest growth sector in US health care, access to palliative care is of utmost importance. However, with the publication of the 4th edition of national guidelines for palliative care in clinical practice, this care becomes even more accessible.

"By definition, palliative care is interdisciplinary care," said Drs. Martha L. Twaddle, clinical professor at Northwestern University's Feinberg School of Medicine, in an interview with MD Magazine ® . "It's about working as a team, and the interdisciplinary model is one in which each of us has the opportunity to seek out-of-the-box needs outside of our field of expertise. We ask health care to come back to what was originally intended ̵

1; caring for people in the context of their family and community and personalizing their care. "

" The guidelines are really important because they say, "These are the essential elements that are essential for palliative care." It helps turn care into the model that we say is so important for the care of critically ill people, "she added

Founded in 2001 and published in 2004, the Clinical Practice Guidelines emphasize Quality Palliative Care critical aspects of the field In the updated edition, the authors call for a critical assessment by the various members of a patient's interdisciplinary team, stressing the importance of the family, not only the biological family, but also the patient community and community Belonging to the patient's support group.

Assessing the capacity and stress of caregivers, as well as transitions in the care of critically ill patients, are further priorities in the updated guidelines, regardless of prognosis, environment and age According to Twaddle, the guidelines for 5-year-olds apply as well as 90-year-olds.

Due to lack of literature, the original guidelines were created by a national consensus in the United States. However, the updated guidelines contain even more critical stakeholders. 16 different organizations participated in the creation of this edition. A systematic review of the evidence available to date has also included the benefits of palliative care and well-researched areas of research that are still needed.

"The guidelines reflect the progress of the field," added Twaddle. "The AIDS epidemic has quite frankly led healthcare to better serve the seriously ill. In this context, the field of palliative medicine was born here.

Twaddle added that a lack of organization significantly influenced today's standardization of palliative care guidelines, which now form the basis of all accreditations in palliative care. For example, the Joint Commission uses the guidelines to review programs to ensure that they receive palliative care.

"The guidelines form the foundation upon which we build our quality metrics and standards," said Twaddle. "In order to measure good care, it needs to be linked and refer to what the guidelines consider important."

She added that pay is also largely governed by the directives, as insurance contracts are often word for word – The guidelines for which palliative care is defined.

Another exciting addition, which according to Twaddle is included in the guidelines, is a focus on collaboration. Although specialists are required, in certain situations the entire patient team is important. Through the creation of 45 different practice examples, consisting of innovations from individuals who care for the needs of critically ill patients, the guidelines emphasize the importance of collaboration.

"We need to create synchronized swimming models," Twaddle said. "We need to use resources mutually and work as a team. The team may not be spatially limited or defined. The team could be bigger. [We have to] Think about what is the ability to meet the needs of patients, such as a practice that works with a community hospice or an emergency room that works with a children's hospital. "

Looking to the future, Twaddle sees the new guidelines as a catalyst for more research because the systemic review revealed gaps in the data needed in this area. She claims that these gaps are a framework for her to work.

"One important thing that needs to be highlighted is the difference between palliative care and hospice care," concluded Twaddle. "Palliative care is for anyone who suffers from a serious illness. Hospice is a form of palliative care for persons at the end of life whose prognosis is several months. All that is palliative care is hospice, but not all that is hospice is palliative care. The guidelines cover the entire roof of palliative care – including, but not limited to, end-of-life care. "


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