gms | German Medical Science

21. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

05.10. - 07.10.2022, Potsdam

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Caring for seriously ill and dying patients in pandemic times – a national strategy

Meeting Abstract

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  • Berenike Pauli - University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Köln, Deutschland
  • Karlotta Schlösser - University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Köln, Deutschland
  • Anne Pralong - University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Köln, Deutschland
  • Julia Strupp - University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Köln, Deutschland
  • Claudia Bausewein - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Farina Hodiamont - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Nathalie Berges - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Anneke Ullrich - University Medical Center Hamburg-Eppendorf, Palliative Care Unit, Department of Oncology, Hematology and Bone Marrow Transplant, Hamburg, Deutschland
  • Christina Gerlach - University Medical Center Hamburg-Eppendorf, Palliative Care Unit, Department of Oncology, Hematology and Bone Marrow Transplant, Hamburg, Deutschland; University Hospital Heidelberg, Department of Palliative Care, Heidelberg, Deutschland
  • Karin Oechsle - University Medical Center Hamburg-Eppendorf, Palliative Care Unit, Department of Oncology, Hematology and Bone Marrow Transplant, Hamburg, Deutschland
  • Jan Philip Weber - Hannover Medical School, Institute for General Practice and Palliative Medicine, Hannover, Deutschland
  • Stephanie Stiel - Hannover Medical School, Institute for General Practice and Palliative Medicine, Hannover, Deutschland
  • Nils Schneider - Hannover Medical School, Institute for General Practice and Palliative Medicine, Hannover, Deutschland
  • Norbert Krumm - University Hospital Aachen, Department of Palliative Medicine, Aachen, Deutschland
  • Roman Rolke - University Hospital Aachen, Department of Palliative Medicine, Aachen, Deutschland
  • Cordula Gebel - University Hospital Jena, Department of Palliative Medicine, Jena, Deutschland
  • Ulrich Wedding - University Hospital Jena, Department of Palliative Medicine, Jena, Deutschland
  • Maximiliane Jansky - Georg-August-University Goettingen, Department of Palliative Medicine, Göttingen, Deutschland
  • Friedemann Nauck - Georg-August-University Goettingen, Department of Palliative Medicine, Göttingen, Deutschland
  • Birgitt van Oorschot - University Wuerzburg, University Hospital Wuerzburg, Interdisciplinary Centre for Palliative Medicine, Würzburg, Deutschland
  • C. Roch - University Wuerzburg, University Hospital Wuerzburg, Interdisciplinary Centre for Palliative Medicine, Würzburg, Deutschland
  • L. Werner - University Wuerzburg, University Hospital Wuerzburg, Interdisciplinary Centre for Palliative Medicine, Würzburg, Deutschland
  • M. Fischer - University Wuerzburg, University Hospital Wuerzburg, Interdisciplinary Centre for Palliative Medicine, Würzburg, Deutschland
  • Manuela Schallenburger - Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, Interdisciplinary Centre for Palliative Care, Düsseldorf, Deutschland
  • Marie Christine Reuters - Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, Interdisciplinary Centre for Palliative Care, Düsseldorf, Deutschland
  • Jacqueline Schwartz - Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, Interdisciplinary Centre for Palliative Care, Düsseldorf, Deutschland
  • Martin Neukirchen - Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, Interdisciplinary Centre for Palliative Care, Düsseldorf, Deutschland; Heinrich Heine University Duesseldorf, University Hospital Duesseldorf, Department of Anesthesiology, Düsseldorf, Deutschland
  • Gülay Ateş - University Hospital Bonn, Department of Palliative Medicine, Bonn, Deutschland
  • Katja Maus - University Hospital Bonn, Department of Palliative Medicine, Bonn, Deutschland
  • Birgit Jaspers - University Hospital Bonn, Department of Palliative Medicine, Bonn, Deutschland
  • Lukas Radbruch - University Hospital Bonn, Department of Palliative Medicine, Bonn, Deutschland
  • Maria Heckel - Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, Erlangen, Deutschland
  • Isabell Klinger - Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, Erlangen, Deutschland
  • Christoph Ostgathe - Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital Erlangen, Department of Palliative Medicine, Comprehensive Cancer Center, CCC Erlangen – EMN, Erlangen, Deutschland
  • Ursula Kriesen - Rostock University Medical Center, Department of Medicine, Clinic III-Hematology, Oncology, Palliative Medicine - CCC Mecklenburg-Vorpommern, Rostock, Deutschland
  • Christian Junghanß - Rostock University Medical Center, Department of Medicine, Clinic III-Hematology, Oncology, Palliative Medicine - CCC Mecklenburg-Vorpommern, Rostock, Deutschland
  • Eva Lehmann - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Daniela Gesell - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Sonja Gauder - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Sophie Meesters - Ludwig-Maximilians-University Munic, University Hospital Munic, Department of Palliative Medicine, Deutschland
  • Christopher Böhlke - University of Freiburg, Faculty of Medicine, Medical Center, Department of Palliative Medicine, Freiburg, Deutschland
  • Gerhild Becker - University of Freiburg, Faculty of Medicine, Medical Center, Department of Palliative Medicine, Freiburg, Deutschland
  • Charlotte Leisse - University of Cologne, Faculty of Medicine and University Hospital, Department I of Internal Medicine, Köln, Deutschland
  • Norma Jung - University of Cologne, Faculty of Medicine and University Hospital, Department I of Internal Medicine, Köln, Deutschland
  • Raymond Voltz - University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Köln, Deutschland; University of Cologne, Faculty of Medicine and University Hospital, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Köln, Deutschland; University of Cologne, Faculty of Medicine and University Hospital, Clinical Trials Center (ZKS), Köln, Deutschland; University of Cologne, Faculty of Medicine and University Hospital, Center for Health Services Research, Köln, Deutschland
  • Steffen T. Simon - University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Köln, Deutschland

21. Deutscher Kongress für Versorgungsforschung (DKVF). Potsdam, 05.-07.10.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. Doc22dkvf246

doi: 10.3205/22dkvf246, urn:nbn:de:0183-22dkvf2468

Veröffentlicht: 30. September 2022

© 2022 Pauli et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Background and status of (inter)national research: During the beginning of the SARS-CoV2 pandemic, medical care focused on providing intensive care beds and ventilation capacities for acutely ill SARS-CoV2 patients. More than 124 000 (03/2022) people died in Germany because of or with COVID-19 so far. In addition, poorer care is described for non-COVID-19 patients, and the German health care system was insufficiently prepared for the challenges of palliative care in times of a pandemic.

Research question and objective: An association of 13 university palliative care facilities (PallPan) within the Network of University Medicine (NUM) investigated how to realize appropriate care for seriously ill, dying, and bereaved people in Germany despite the challenges affiliated with the pandemic. Based on identifying burdens, challenges, and solutions for inpatient/community (palliative) care under pandemic conditions, PallPan developed a national strategy for the care of seriously ill and dying adults and their relatives in pandemic times entailing: a) recommendations for action for general/specialized palliative care of seriously ill and dying patients with/without infection, b) collection and development of information material for a web-based platform, and c) identification of variables for the data collection on palliative care in pandemic times.

Method or hypothesis: In 16 studies, the experiences of 1700 affected patients, caregivers, and persons responsible for health care, administration, and politics were assessed. (Online) surveys, qualitative interviews, and an international literature search were conducted from 08/20–04/21. Based on these results and supported by 120 experts from different areas of the health care system, a national strategy was developed and consented to by using a modified Delphi process.

Results: The study results show that strict isolation for patients/residents, including visiting bans, led to social isolation and suffering. However, creative and innovative initiatives also emerged to maintain adequate palliative care. These findings have been incorporated into 33 recommendations and many best practice examples on how to provide appropriate care for seriously ill and dying people during a pandemic. The recommendations address the micro, meso, and macro levels for general/specialized palliative care of infected and non-infected patients in the last months of life and the dying phase in a pandemic. A web-based platform, training materials, and an assistance service for bereaved relatives were developed.

Discussion: Preparedness for further pandemics requires national recommendations and concepts that focus on general/specialized inpatient/community palliative care. In this way, high-quality end-of-life and farewell care can also be made possible even during a pandemic.

Practical implications: As a result, an information platform with recommendations and best practice examples specific to the pandemic (https://pallpan.de/) an interactive platform for bereaved relatives and e-learning for health care professionals are available.

Appeal for practice (science and/or care) in one sentence: Implementing the recommendations in everyday care at all levels should be the primary goal.

Funding: Einzelförderung (BMG, DRV, BMBF, DFG, etc); 01KX2021